阻塞性睡眠呼吸暂停低通气综合征伴冠心病患者血清总

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1、阻塞性睡眠呼吸暂停低通气综合征伴冠心病患者血清总胆红素和γ-谷氨酰转移酶的测定及临床意义摘要目的通过检测阻塞性睡眠呼吸暂停低通气综合征（obstructivesleepapneahypopneasyndrome,OSAHS）及OSAHS合并冠心病（coronaryheartdisease,CHD）患者血清总胆红素（totalbilirubin,TBIL）及γ-谷氨酰转移酶(gamma-glutamyltransferase,GGT)的变化，研究TBIL及GGT与OSAHS及OSAHS并CHD之间的相关性，探讨OSAHS的病理生理变化及OSAHS并CHD的发病机制。方法选择我院经多导睡眠

2、图(polysomnography,PSG)监测确诊的OSAHS患者90例为实验组，其中单纯OSAHS患者45例，OSAHS并CHD患者45例；另选择我院同期健康体检者24例为正常对照组。于睡眠呼吸监测次日晨起采取空腹肘静脉血3ml，通过全自动生化分析仪检测各组血清TBIL、GGT及相关生化指标的水平。统计分析这些生化指标在各组间的差异以及TBIL、GGT与OSAHS、OSAHS并CHD之间的相关关系。结果OSAHS组及OSAHS并CHD组与正常对照组比较，血清TBIL明显降低(P＜0.01)，GGT明显升高（P＜0.01），差异有统计学意义；OSAHS并CHD组与OSAHS组比较，血

3、清TBIL亦明显降低(P＜0.01)，GGT明显升高(P＜0.01)，差异有统计学意义。结论OSAHS患者存在TBIL及GGT代谢异常，OSAHS并CHD患者TBIL及GGT代谢异常更加显著，血清TBIL、GGT的异常代谢可能参与了OSAHS并CHD的发生。关键词阻塞性睡眠呼吸暂停低通气综合征冠心病总胆红素γ-谷氨酰转移酶4TheChangesandClinicalSignificanceofSerumTBILandGGTLevelsinOSAHSComplicatedwithCHDAbstractObjectiveToinvestigatetheserumtotalbilirubin

4、(TBIL)andgamma-glutamyltransferase(GGT)levelsinpatientswithobstructivesleepapneahypopneasyndrome(OSAHS)andinthosewithobstructivesleepapneahypopneasyndromeassociatedcoronaryheartdisease(OSAHS+CHD),andtostudythecorrelationbetweenthetwobiomarkersandOSAHSandOSAHS+CHD,inordertoexplorethechangeofphysi

5、ologyinpatientswithOSAHSandthepathogenesisofOSAHS+CHD.MethodsNinetypatientsconfirmedwithOSAHSbypolysomnography(PSG)wereselected.Thesubjectscomprised45pureOSAHSpatientsand45patientswithOSAHS+CHD.Inaddition,24contemporaryhealthysubjectsundergoingphysicalexaminationwereselectedtobethenormalcontrols

6、.3mlfastingvenousbloodwasobtainedfromallstudiedsubjectsthenextmorningaftersleepapneamonitoring.SerumTBILandGGTconcentrationsweremeasuredbyusingautomaticbiochemicalanalyzer.ThevariationsofTBILandGGTamongthe3groupswerecomparedbystatisticalsoftware.ResultsTheserumTBILlevelsofOSAHSpatientsandOSAHS+C

7、HDweresignificantlylowerthanthatofcontrolsubjects(P