辛伐他汀改善OSAS并高血压血脂正常患者血栓前状态临床评价.docVIP

辛伐他汀改善OSAS并高血压血脂正常患者血栓前状态临床评价 　　[摘要] 目的 评价辛伐他汀对阻塞性睡眠呼吸暂停综合征（OSAS）同时合并高血压但血脂正常患者的血栓前状态的临床意义。 方法 选择2011年1月～2014年6月收治的80例OSAS合并高血压血脂正常患者，按随机抽样法分成常规组及观察组，每组各40例，其中常规组给予常规治疗，观察组在常规治疗基础上给予辛伐他汀；另选40例健康体检者为对照组。治疗8周后检测并比较治疗前后各组一氧化氮（NO）、内皮素（ET-1）、血管性假性血友病因子（vWF）以及组织型纤溶酶原激活剂（t-PA）水平的差异。 结果 治疗前观察组、常规组NO、t-PA较对照组降低，而ET-1、vWF较对照组升高，差异均有统计学意义（P0.05）。治疗后观察组、常规组NO、t-PA较治疗前显著升高，ET-1、vWF较治疗前显著降低，且观察组的变化幅度较常规组更显著，差异均有统计学意义（P0.05）。结论 辛伐他汀应用于OSAS合并高血压且血脂正常的患者，可提高该类患者的NO、t-PA同时降低ET-1、vWF，这种非调脂的机制可改善患者的血栓前状态。 　　[关键词] 阻塞性睡眠呼吸暂停综合征；高血压；辛伐他汀；血栓前状态 　　[中图分类号] R544.1；R56 [文献标识码] B [文章编号] 1673-9701（2015）13-0074-03 　　[Abstract] Objective To investigate the effect of simvastatin on prothrombotic state in OSAS patients with hypertension without hyperlipemia. Methods Eighty OSAS patients with hypertension without hyperlipemia were enrolled from January 2011 to June 2014，and randomly divided into simvastatin group（40 cases） and conventional group（40 cases）（oral taken simvastatin or placeb once every night in addition of routine antihypertensive drugs）.Forty healthy subjects were also recruited as control.All cases were followed up for eight weeks. Serum holesterol，nitric oxide（NO），emdothelin-1（ET-1），von Willebrand-factor（vWF） and tissue-type plasminogen activator（t-PA） levels were determined in each case before and after eight weeks orsuvastatin medication. Results Before treatment NO，t-PA levels in simvastatin group and conventional group were lower than the healthy group，ET-1， vWF levels were higher than those of control group，the differences were statistically significant（P0.05）. After treatment NO，t-PA levels in simvastatin group and conventional group increased compared with before treatment，but simvastatin group increased more significantly，ET-1，vWF levels in simvastatin group and conventional group were lower than before treatment，but simvastatin group they were more significantly lower， with statistically significant difference （P0.05）. Conclusion In patients of OSAS patients with hyperte