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目的探讨能否根据阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道手术后机体血脂的改善状况作为直观、有效评估手术疗效的方法之一。方法回顾性分析2010~2013年间北京朝阳医院耳鼻咽喉头颈外科手术治疗的OSAHS患者血脂资料,筛选出具有手术前未治疗期、术前围手术期及术后恢复期后三次血脂检查结果并且期间无降脂类药物使用史的患者共19例,分析血脂数值在观察期内的变化特点。结果手术前未治疗期的血脂检查时间为(12.5±5.6)个月,手术恢复期后血脂检查时间(11.8±6.2)个月。OSAHS患者手术前未治疗期,手术时及手术恢复期后,均无降脂药物服用史情况下,血清总胆固醇(TC)含量变化差异有统计学意义(F=9.03,P=0.000 7);手术前未治疗期和手术时比较,差异有统计学意义(P<0.001),手术时与手术恢复期后,差异有统计学意义(P=0.017);血清脂蛋白(a)[LP(a)]含量变化差异有统计学意义(F=5.49,P=0.009),手术前未治疗期和手术时比较,差异有统计学意义(P=0.007),手术时与手术恢复期后,差异有统计学意义(P=0.007)。结论 OSAHS患者间断性缺氧可以导致机体血脂升高,手术治疗可改善OSAHS患者存在的脂质代谢紊乱状态,血清总胆固醇和血清脂蛋白(a)均是对机体低氧敏感的指标,早期发现、积极治疗OSAHS对预防治疗心血管疾病意义重要,更多的心血管指标建议被探索和评估手术对OSAHS改善的证据。
Objective To investigate whether the improvement of the blood lipids in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) after upper airway surgery can be used as an intuitive and effective method to evaluate the efficacy of surgery. Methods The data of blood lipids in OSAHS patients undergoing surgery for otolaryngology and head and neck surgery in Beijing Chaoyang Hospital from 2010 to 2013 were retrospectively analyzed. The results of three tests of blood lipids before and after surgery, preoperative and postoperative recovery were screened out. A total of 19 patients with lipid-lowering drug use history, analysis of blood lipid values in the observation period changes. Results The duration of lipopenia before treatment was (12.5 ± 5.6) months after operation and 11.8 ± 6.2 months after operation recovery. The serum total cholesterol (TC) levels in OSAHS patients before treatment were significantly lower than those before treatment (both F = 9.03, P = 0.0007). The difference was statistically significant (P <0.001) between the untreated stage and the surgical stage, and the difference was statistically significant (P = 0.017) between the operation and the recovery stage. The serum level of lipoprotein (a) [LP )], The difference was statistically significant (F = 5.49, P = 0.009). There was a significant difference between the preoperative and untreated stages (P = 0.007) Statistical significance (P = 0.007). Conclusions Intermittent hypoxia in patients with OSAHS can lead to elevated blood lipids. Surgical treatment can improve lipid metabolic disorder in OSAHS patients. Both serum total cholesterol and serum lipoprotein (a) are indicators of hypoxia sensitivity in the body. , Active treatment of OSAHS is important for the prevention and treatment of cardiovascular disease, and more cardiovascular recommendations are being explored and evaluated for evidence of improvement in OSAHS.