老年睡眠呼吸暂停患者动脉硬化危险因素的探讨.docxVIP

老年睡眠呼吸暂停患者动脉硬化危险因素的探讨 目的探讨老年阻塞型睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome, OSAS)患者超敏 C 反应蛋白(High sensitivity C reactive protein , Hs-CRP )、同型半 胱氨酸 (Homocysteine, Iley) TG TC、LDL-C水平变化及其与颈动脉内膜 中层厚度(Carotid artery intima-media thickness, CIMT) 斑块 的相关性。方法选取老年高血压、2型糖尿病患者129例，根据有无 OSAS分为OSAS组(60例)和非OSAS组(69例)，选取健康老年人 30例作为正常对照组，所有入选者均记录年龄、性别、身高和体重， 检测Hs-CRP Hey、TG、TC、LDL-C和颈动脉内膜中层厚度(CIMT), 对比 OSAS 组和非 OSAS 组 Hs-CRP Hey、TG、TC、LDL-C 和 CIMT 的差 异,OSAS组和非OSAS组分别与正常对照组比较各指标差异。分析CIMT 和颈部斑块分别与Hs-CRP Hey、TG、TC、LDL-C年龄及BMI的相 关性。结果(1) OSAS组与正常对照组比较，Hs-CRP、Hey、CIMT、 TG、TC、LDL-C均高于正常对照组，差异有统计学意义(P0.05)。非 OSAS 组与正常对照组比较，Hs-CRP、Hey、CIMT、TG、TC、LDL-C 均 高于正常对照组，差异有统计学意义(P0. 05)o OSAS组与非OSAS组 比较，Hs-CRP、Hey、CIMT及斑块积分均高于非OSAS组，差异有统 计学意义(P0.05)。(2)相关分析显示，OSAS组CIMT与年龄、BMI、 TG、TC、LDL-C、Hs-CRP、Hey均正相关。OSAS组斑块积分与年龄、 BMI、TG、TC、LDL-C、Hs-CRP、Hey均正相关。(3)多元线性回归分 析显示，OSAS组年龄、BMI、LDL-C、Hs-CRP、Hey均是CIMT的影响 因素(均 p0. 05) o OSAS 组年龄、BMK LDL-C、Hs-CRP、Hey 均是颈 动脉斑块的影响因素(均P0. 05) o结论 (1) OSAS患者Hs-CRP、 Hey、CIMT及颈动脉斑块水平高于正常对照组，高于非OSAS组，是 动脉粥样硬化(Atherosclerosis, AS)的易患人群，OSAS是老年AS 的危险因素。(2) CIMT与年龄、BMI LDL-C、Hs-CRP、Iley是老年 OSAS患者AS的危险因素。(3)Hs-CRP、Hey水平变化可能对老年OSAS 患者AS的预防有重要作用。 关键词阻塞型睡眠呼吸暂停低通气综合征，Hs-CRP, Hey, CIMT Objective To investigate the Hs-CRP (High sensitivity C reactive protein), Hey (Homocysteine), TG, TC, LDL-C levels in elderly OSAS (Obstructive sleep apnea hypopnea syndrome) patients, and the correlation between them and CIMT (Carotid artery intima-media thickness), Carotid artery plaque? Methods 129 elderly hypertension and type 2 diabetes patients were included in the study. According to the presence or absenee of OSAS, we divided them into OSAS group (60 cases) and non OSAS group (69 cases)?Meanwhile we selected 30 healthy elderly citizens as normal control grou. All patients were recordedage, sex, height and weight, and tested Hs-CRP, Iley, TG, TC, I.DL-C and CI MT. Comparing wi th the differences between the OSAS group and non OSAS group, which were compared with the normal control gr