Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome
Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome
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DOI：
10.1164/ajrccm.153.6.8665063
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发表时间：
1996-06-01
影响因子：
24.7
通讯作者：
Kuno, K
中科院分区：
文献类型：
--
作者：
Chin, K;Ohi, M;Kuno, K
在阻塞性睡眠呼吸暂停综合征（OSAS）患者中，凝血系统可能导致心血管事件风险增加，这些事件最常发生在早晨。经鼻持续气道正压通气（NCPAP）治疗可提高OSAS患者的病死率。我们在下午（3：30 P.M.）测量了血浆纤维蛋白原浓度，这是心血管事件的独立危险因素。第二天早上醒来（8：30）11例OSAS患者（呼吸暂停低通气指数> 20）在NCPAP治疗前后的变化。同时测定红细胞压积、C反应蛋白和血浆总蛋白。早晨的血浆纤维蛋白原和红细胞压积水平（298 +/- 16 mg/dl和48.5 +/-1.5%，平均值+/- SEM）显著高于前一天下午（275 +/- 14 mg/dl和46.6 +/- 1.3%）（纤维蛋白原，p < 0.02;红细胞压积，p < 0.005）。根据红细胞压积和总血浆蛋白可以预测的切变率为208倒数秒时的全血粘度（WBV）也在上午（4.98 +/- 0.20/s）显著高于下午（4.73 +/- 0.17/s）（p < 0.005）。这些增加的血浆纤维蛋白原浓度和WBV在上午消失后NCPAP治疗。NCPAP治疗诱导的血浆纤维蛋白原浓度和WBV早晨升高的减弱可能有助于OSAS患者心血管事件死亡率的总体改善。
In patients with obstructive sleep apnea syndrome (OSAS), the blood coagulation system may contribute to an increased risk of cardiovascular events, which occur most frequently in the morning. Nasal continuous positive airway pressure (NCPAP) treatment can improve the mortality of patients with OSAS. We measured the plasma fibrinogen concentration, which is an independent risk factor for cardiovascular events, in the afternoon (3:30 P.M.) and the next morning upon awakening (8:30 A.M.) in 11 patients with OSAS (apnea and hypopnea index > 20) before and after NCPAP therapy. We also measured the hematocrit, the C-reactive protein, and the total plasma protein at the same time. The plasma fibrinogen and hematocrit levels in the morning (298 +/- 16 mg/dl and 48.5 +/- 1.5%, mean +/- SEM) were significantly higher than on the previous afternoon (275 +/- 14 mg/dl and 46.6 +/- 1.3%) (fibrinogen, p < 0.02; hematocrit, p < 0.005). The whole blood viscosity (WBV) at a shear rate of 208 inverse seconds, which can be predicted based on the hematocrit and total plasma protein, was also significantly higher in the morning (4.98 +/- 0.20/s) than in the afternoon (4.73 +/- 0.17/s) (p < 0.005). These increases in the plasma fibrinogen concentration and the WBV in the morning disappeared after NCPAP treatment. The attenuation of morning increases in the plasma fibrinogen concentration and WBV induced by NCPAP treatment may contribute to an overall improvement in the mortality from cardiovascular events in patients with OSAS.