摘要
目的:研究阻塞性睡眠呼吸暂停(obstructivesleepapnea,OSA)患者血浆中一氧化碳及间接胆红素(间胆)水平变化及其临床意义。方法:测定111例OSA患者和30名正常人血浆一氧化碳和间胆水平。其中20例中、重度患者使用持续气道内正压通气(continuousairwaypositivepressure,CPAP)呼吸机治疗30日,于治疗前、治疗第一日、治疗1个月后分别测定一氧化碳和间胆水平。结果:①OSA患者血浆中一氧化碳水平显著高于正常人,重度组一氧化碳水平显著高于轻、中度组,OSA合并高血压组的一氧化碳水平亦显著高于无伴高血压组(均为P<0.05);②正常人血浆中间胆水平显著高于OSA患者;轻、中度组间胆水平显著高于重度组,OSA无伴高血压组血浆间胆显著高于合并高血压组;③20例OSA患者血浆一氧化碳于治疗1个月后显著降低,间胆则显著升高(均为P<0.05);④OSA患者血浆中一氧化碳与舒张压和动脉血氧饱和度小于0.90占总睡眠时间比值均呈正相关,血间胆与动脉血氧饱和度小于0.90占总睡眠时间比值和呼吸暂停低吸气指数均呈负相关,一氧化碳与间胆呈负相关。结论:低血氧是引起OSA患者一氧化碳显著增高或间胆显著降低的原因,一氧化碳和间胆都可能参与了OSA的病理生理过程,患者血浆中一氧化碳和间胆水平可考虑作为考察其是否有合并症的指标。
Objective:To study the significance of changes in plasma carbon monoxide(CO)and indirect bilirubin(IDB)level in patients with obstructive s leep apnea(OSA).Methods :Blood samples were obtained for measurement of plasma CO and IDB in 30cases of controls and 111patients with OSA.Twenty cases of moderate to severe patients were treated w ith continuous air-way positive pressure(CPAP)every night for 30days.Their plasma CO and IDB were measured and compared before,an overnight or a month after CPAP application.Results:①Plasma CO level in OSA was significan tly higher than that in controls and w as higher in severe cases than that in mild and moderate patients.Plasma CO level wa s also higher in OSA accompanied with hypertension than those without hypertension(P<0.05).②Plasma IDB level in controls was sign ificantly higher than that in OSA.And plasma IDB levels in mild and moderate OSA were s ignificantly higher than that in sev ere cases.Moreover,plasma IDB in OSA without (hypertension)was also significantly higher than t hat accompanied with hypertension(P<0.05).③There were no significant changes of plasma CO and IDB in 20men w ith OSA after an overnight CPAP appli cation,but significant decrease of CO and signifi-cant increase of IDB were noted after one month of CPAP.④Multiple linear regression showed t hat plasma CO level in OSA was sig-nificantly correlated with DBP and R.Plasma IDB level in OSA was signific antly correlated with AHI and R.Linear correlation anal-ysis indicated plasma CO level in OSA was significantly correlated with I DB.Conclusion:Significant increase of plasma CO or de-crease of plasma IDB in OSA are mainly caused by hypoxia.Plasma CO and IDB i n OSA may be involved in the pathophysiological process of OSA.The levels of CO or IDB in OSA may be regarded as one of the parameter of complication.
出处
《新医学》
北大核心
2003年第1期17-19,共3页
Journal of New Medicine
基金
广西壮族自治区卫生厅科研课题(22001050)
