目的 探究阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与凝血功能之间的相关性,为临床指导OSA患者的治疗提供参考。方法 以2007年8月~2020年3月间因疑诊OSA行多道睡眠图(PSG)监测的受试者为研究对象。收集各受试者人口学、体格检...目的 探究阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与凝血功能之间的相关性,为临床指导OSA患者的治疗提供参考。方法 以2007年8月~2020年3月间因疑诊OSA行多道睡眠图(PSG)监测的受试者为研究对象。收集各受试者人口学、体格检查、生化检验及PSG数据,共纳入1113例成人研究对象进行统计分析。比较各OSA组间凝血功能指标的差异,包括细胞比积(PCV)、平均血小板体积(MPV)、血小板数量(PLT)、血小板平均宽度(PDW)、血小板压积(PCT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)等。利用多变量线性回归分析校正混杂因素,分析OSA特征指标与凝血功能的相关性。结果 在OSA不同严重程度亚组之间,PCV和PDW差异有统计学意义(F=4.670、4.727,P均<0.05),其余指标均无显著差异。多元线性回归发现,在校正性别、年龄、身高、体重、肝肾功能、吸烟、饮酒的影响后,呼吸暂停低通气指数(AHI)与PLT、PCT及PDW正相关(r=0.381、0.320、0.143,P均<0.05);氧降指数(oxygen desaturation index,ODI)与PLT、PCT及PT之间有相关性(r=0.379、0.320、0.202,P均<0.05);血氧饱和度小于90%时间占监测总时间的百分比(the percent of the total record time spent below 90% oxygen saturation,TS90%)与PCV和FIB之间呈正相关(r=0.477、0.267,P均<0.05);夜间最低血氧饱和度(LSaO_(2))与FIB呈负相关(β=-0.086,r=0.268,P<0.05),同时与TT正相关(r=0.201,P<0.05);微觉醒指数(arousal index,ArI)与APTT、PT之间亦存在弱相关(r=0.188、0.208,P<0.05);PDW与不同程度缺氧指标之间均有相关性(P<0.05)。结论 OSA患者随着机体缺氧程度不断增加,凝血功能紊乱主要表现在机体出现高凝状态,血小板数量、活性增强和共同凝血途径中FIB活化加速为导致凝血功能亢进的主要因素。展开更多
Objective:To investigate the effects of different follow-up systems in China and Germany on ventilator therapy in patients with obstructive sleep apnea syndrome.Method:From March 2013 to October 2015,three hundred pat...Objective:To investigate the effects of different follow-up systems in China and Germany on ventilator therapy in patients with obstructive sleep apnea syndrome.Method:From March 2013 to October 2015,three hundred patients with moderate to severe obstructive sleep apnea syndrome and those who are suitable for ventilator treatment were followed up according to the follow-up system of both China and Germany.The follow-up was carried out for one year to compare the rate of loss to follow-up,ventilator therapy compliance,treatment effect,ventilator side effects and others in the two groups of patients.Statistical analysis was performed using x2 test,P<0.05 for the difference was statistically significant.Results:The rate of loss to follow-up in the German group was lower than that in the Chinese group.The compliance of the German group with respiratory therapy was lower than that of the Chinese group.The side effects of ventilator treatment were lower than those in the Chinese group(P<0.05).Conclusion:The German follow-up system is more effective than the Chinese follow-up system in improving the compliance and effectiveness of ventilator therapy in patients with obstructive sleep apnea syndrome.展开更多
文摘目的 探究阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与凝血功能之间的相关性,为临床指导OSA患者的治疗提供参考。方法 以2007年8月~2020年3月间因疑诊OSA行多道睡眠图(PSG)监测的受试者为研究对象。收集各受试者人口学、体格检查、生化检验及PSG数据,共纳入1113例成人研究对象进行统计分析。比较各OSA组间凝血功能指标的差异,包括细胞比积(PCV)、平均血小板体积(MPV)、血小板数量(PLT)、血小板平均宽度(PDW)、血小板压积(PCT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)等。利用多变量线性回归分析校正混杂因素,分析OSA特征指标与凝血功能的相关性。结果 在OSA不同严重程度亚组之间,PCV和PDW差异有统计学意义(F=4.670、4.727,P均<0.05),其余指标均无显著差异。多元线性回归发现,在校正性别、年龄、身高、体重、肝肾功能、吸烟、饮酒的影响后,呼吸暂停低通气指数(AHI)与PLT、PCT及PDW正相关(r=0.381、0.320、0.143,P均<0.05);氧降指数(oxygen desaturation index,ODI)与PLT、PCT及PT之间有相关性(r=0.379、0.320、0.202,P均<0.05);血氧饱和度小于90%时间占监测总时间的百分比(the percent of the total record time spent below 90% oxygen saturation,TS90%)与PCV和FIB之间呈正相关(r=0.477、0.267,P均<0.05);夜间最低血氧饱和度(LSaO_(2))与FIB呈负相关(β=-0.086,r=0.268,P<0.05),同时与TT正相关(r=0.201,P<0.05);微觉醒指数(arousal index,ArI)与APTT、PT之间亦存在弱相关(r=0.188、0.208,P<0.05);PDW与不同程度缺氧指标之间均有相关性(P<0.05)。结论 OSA患者随着机体缺氧程度不断增加,凝血功能紊乱主要表现在机体出现高凝状态,血小板数量、活性增强和共同凝血途径中FIB活化加速为导致凝血功能亢进的主要因素。
文摘Objective:To investigate the effects of different follow-up systems in China and Germany on ventilator therapy in patients with obstructive sleep apnea syndrome.Method:From March 2013 to October 2015,three hundred patients with moderate to severe obstructive sleep apnea syndrome and those who are suitable for ventilator treatment were followed up according to the follow-up system of both China and Germany.The follow-up was carried out for one year to compare the rate of loss to follow-up,ventilator therapy compliance,treatment effect,ventilator side effects and others in the two groups of patients.Statistical analysis was performed using x2 test,P<0.05 for the difference was statistically significant.Results:The rate of loss to follow-up in the German group was lower than that in the Chinese group.The compliance of the German group with respiratory therapy was lower than that of the Chinese group.The side effects of ventilator treatment were lower than those in the Chinese group(P<0.05).Conclusion:The German follow-up system is more effective than the Chinese follow-up system in improving the compliance and effectiveness of ventilator therapy in patients with obstructive sleep apnea syndrome.
