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目的:探索阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并发冠心病患者sCD40L水平的变化,进一步了解OSASH并发冠心病的机理。方法:111例经过我院睡眠中心诊断和(或)治疗的患者行血清sCD40L检测,其中21例为正常组,22例冠心病患者为冠心病组,33例OSAHS患者,依据AHI分为轻度组、中度组和重度组,35例OSAHS合并冠心病患者,依据AHI分为3个小组,其中33例重度OSAHS患者予3个月nCPAP治疗后再次行PSG监测及血清检测。结果:OSAHS患者和冠心病患者sCD40L水平高于正常人(P<0.01)。OSAHS并发冠心病患者sCD40L水平高于冠心病患者和OSAHS患者(P<0.01)。sCD40L水平随着OSAHS患者严重程度升高而升高。sCD40L水平随着OSAHS并发冠心病患者严重程度升高而升高。重度OSAHS患者经CPAP3个月治疗后sCD40L水平下降。结论:sCD40L可作为OSAHS病情评价指标,对预测OSAHS并发冠心病有意义,CPAP治疗可能减缓OSAHS并发冠心病进程。
Objective: To explore the changes of sCD40L levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with coronary heart disease and to further understand the mechanism of OSASH complicated with coronary heart disease. Methods: Serum sCD40L was detected in 111 cases diagnosed and / or treated in our hospital’s sleep center. Twenty-one of them were in normal group, 22 cases of coronary heart disease were coronary heart disease group and 33 cases of OSAHS were classified as mild 35 patients with OSAHS complicated with coronary heart disease were divided into 3 groups according to AHI. Among them, 33 patients with severe OSAHS were treated with nCPAP for 3 months and re-performed PSG monitoring and serum test. Results: The levels of sCD40L in patients with OSAHS and coronary heart disease were significantly higher than those in normal controls (P <0.01). The level of sCD40L in OSAHS patients with coronary heart disease was higher than that in patients with coronary heart disease and OSAHS (P <0.01). The level of sCD40L increases with the severity of OSAHS patients. The level of sCD40L increased with the severity of OSAHS complicating coronary heart disease. Severe OSAHS patients after 3 months of CPAP treatment sCD40L levels decreased. Conclusion: sCD40L can be used as an index to evaluate the severity of OSAHS. It is significant for predicting OSAHS complicated with coronary heart disease. CPAP may slow down the progression of OSAHS complicated with coronary heart disease.