摘要
目的观察冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的冠状动脉狭窄程度及血清胱抑素C(CysC)的变化。方法采用回顾性研究的方法,纳入162例冠心病且有夜间睡眠打鼾、呼吸暂停或白天嗜睡症状的患者,根据睡眠监测结果分为单纯冠心病组(C组)62例[呼吸暂停低通气指数(AHI)<5次/h]和冠心病合并OSAHS组(CO组)100例(AHI≥5次/h),再依据AHI将CO组分为轻度组24例、中度组28例和重度组48例;另以冠状动脉造影证实狭窄<50%且否认夜间睡眠打鼾的患者52例为对照组(N组)。计算Gensini评分评估冠状动脉狭窄程度,检测空腹血清CysC水平。采用SPSS 20.0统计软件比较各组间冠状动脉狭窄程度及血清CysC水平的差异。结果 CO组Gensini评分高于N组和C组(23.58±25.78比2.47±2.91和13.89±24.19,P<0.01和P<0.05),且重度OSAHS组Gensini评分高于轻度组(27.71±28.26比15.71±18.22,P<0.05);CO组血清CysC水平高于N组和C组[(1.02±0.20)mg/L比(0.87±0.14)mg/L和(0.87±0.18)mg/L,均为P<0.05],且重度OSAHS组血清CysC水平高于轻度组和中度组[(1.10±0.17)mg/L比(0.89±0.15)mg/L和(1.02±0.21)mg/L,P<0.01和P<0.05]。结论冠心病合并OSAHS患者的血清CysC水平高于单纯冠心病患者和无冠心病者;冠心病合并OSAHS患者的冠状动脉狭窄程度较单纯冠心病患者严重。
Objective To observe the changes of coronary artery stenosis and serum cystatin C（ CysC） in patients with coronary artery disease（ CAD） and obstructive sleep apnea hypopnea syndrome（ OSAHS）. Methods A retrospective study was conducted in 162 patients with CAD,who were divided into simple coronary heart disease group（ C group,62 cases） and CAD combined with OSAHS group（ CO group,100 cases） [apnea hypopnea index（ AHI） ≥5/h]. Then according to AHI,CO group was divided into mild CO group of 24 cases,moderate CO group of 28 cases and severe CO group of 48 cases; another group with coronary angiography confirmed stenosis 50% while denied nocturnal sleep snoring patients of 52 cases was taken as control（ N group）. Gensini score was calculated to assess the degree of coronary artery stenosis and to detect fasting serum CysC levels. SPSS 20. 0 statistical software was used to compare the degree of coronary artery stenosis and serum CysC level in each group. Results The Gensini score in the CO group was significantly higher than that in the N group and the C group（ 23. 58 ± 25. 78 vs. 2. 47 ± 2. 91 and13. 89 ± 24. 19,P〈0. 01 and P〈0. 05）,and the severe CO group was significantly higher than that of mild CO group（ 27. 71 ± 28. 26 vs. 15. 71 ± 18. 22,P〈0. 05）. The serum CysC of CO group was significantly higher than that of N group and C group [（ 1. 02 ± 0. 20） mg/L vs.（ 0. 87 ± 0. 14） mg/L and（ 0. 87 ± 0. 18）mg/L,both P〈0. 05],the levels of serum CysC in severe CO group were significantly higher than those in mild CO and moderate CO group [（ 1. 10 ± 0. 17） mg/L vs.（ 0. 81 ± 0. 15） mg/L and（ 1. 02 ± 0. 21） mg/L,P〈0. 01 and P〈0. 05,respectively]. Conclusions The level of CysC in patients with coronary heart disease and OSAHS was significantly higher than that in patients with coronary heart disease and those without coronary heart disease; the degree of coronary stenosis in patients with combined coronary heart disease and OSAHS was more severe than that in patients with coronary heart disease without OSAHS.
出处
《中国心血管杂志》
2017年第4期268-272,共5页
Chinese Journal of Cardiovascular Medicine
