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目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对冠状动脉慢血流(CSF)患者血管内皮功能的影响。方法选择冠状动脉造影(CAG)正常但存在CSF的患者90例,依据夜间多导睡眠图(PSG)结果,分为OSAHS组(n=39)和非OSASH组(n=51),分别测定2组患者肱动脉血流介导的内皮依赖性舒张功能(FMD),血浆内皮素-1(ET-1)、一氧化氮(NO)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)水平的变化。结果 OSAHS组患者的FMD、NO较非OSAHS组明显下降(P<0.05),ET-1、TNF-α、hs-CRP较非OSAHS组明显升高(P<0.01)。OSAHS组的呼吸暂停低通气指数(AHI)和血氧饱和度(SaO_2)<90%时间与FMD呈明显负相关,夜间最低脉搏血氧饱和度(LSpO_2)与FMD呈明显正相关。结论 OSAHS能明显降低CSF患者的血管内皮功能。
Objective To investigate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on vascular endothelial function in patients with coronary artery disease (CSF). Methods Ninety patients with normal coronary artery angiography (CAG) but with CSF were selected and divided into OSAHS group (n = 39) and non-OSASH group (n = 51) according to night polysomnography (PSG) The brachial artery-mediated endothelium-dependent vasodilation (FMD), plasma ET-1, NO, hs-CRP and tumor necrosis factor -α (TNF-α) levels. Results The levels of FMD and NO in OSAHS patients were significantly lower than those in non-OSAHS patients (P <0.05). The levels of ET-1, TNF-α and hs-CRP in OSAHS patients were significantly higher than those in non-OSAHS patients (P <0.01). OSAHS group had a significant negative correlation between FMD and apnea hypopnea index (AHI) and blood oxygen saturation (SaO_2) <90%, while nighttime minimum pulse oxygen saturation (LSpO_2) had a positive correlation with FMD. Conclusion OSAHS can significantly reduce the vascular endothelial function in patients with CSF.