Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial
Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial
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DOI：
10.1136/thx.2008.097931
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发表时间：
2009-01-01
期刊：
影响因子：
10
通讯作者：
Stradling, J. R.
中科院分区：
文献类型：
--
作者：
Kohler, M.;Ayers, L.;Stradling, J. R.
背景：在流行病学和观察性研究中，阻塞性睡眠呼吸暂停综合征（OSAS）与心血管疾病有关。持续气道正压通气（CPAP）是OSAS的治疗选择，但这种干预对动脉粥样硬化过程中全身炎症的影响尚不清楚。方法：100例中重度OSAS患者随机分为治疗组（n = 51）和亚治疗组（n = 49）CPAP治疗4周，以研究积极治疗对炎症标志物如高敏C反应蛋白（hsCRP）、白细胞介素（IL）6、结果：与亚治疗对照组相比，4周治疗性CPAP没有显著改变hsCRP的血液水平（中位数变化之间的差异为20.24 mg/l（95%CI-0.88至+0.24）; p = 0.30）。与亚治疗CPAP相比，治疗CPAP后IL 6和IFN γ的血浆水平没有显著变化（中位数变化之间的差异为+0.52和-0.07 pg/ml（95% CI -0.72至+1.94和-0.81至+0.44）;分别为p = 0.45和p = 0.82）。此外，与亚治疗对照组相比，4周治疗性CPAP并未显著改变血浆脂联素水平（中位数变化之间的差异为+0.05 pg/ml（95% CI -0.36至+0.47）; p = 0.84）。如果hsCRP值高于8毫克/升的患者在基线被排除在外，hsCRP，IL 6，IFN γ和脂联素的变化之间的差异4周后的CPAP较小，并再次没有统计学差异groups.Conclusions：4周的CPAP治疗对炎症和脂联素的血液标志物中重度阻塞性睡眠呼吸暂停患者没有有益的影响。
Background: Obstructive sleep apnoea syndrome (OSAS) has been associated with cardiovascular disease in epidemiological and observational studies. Continuous positive airway pressure (CPAP) is the treatment of choice for OSAS, but the impact of this intervention on systemic inflammation involved in the atherosclerotic process remains unclear.Methods: 100 men with moderate-severe OSAS were randomised to therapeutic (n = 51) or subtherapeutic (n = 49) CPAP treatment for 4 weeks to investigate the effects of active treatment on inflammatory markers such as highly sensitive C reactive protein (hsCRP), interleukin (IL) 6, interferon gamma (IFN gamma) and anti-inflammatory adiponectin.Results: 4 weeks of therapeutic CPAP did not significantly change blood levels of hsCRP compared with the subtherapeutic control group (difference between median changes 20.24 mg/l (95% CI -0.88 to +0.24); p = 0.30). Plasma levels of IL6 and IFN gamma did not change significantly following therapeutic compared with subtherapeutic CPAP (difference between median changes +0.52 and -0.07 pg/ml (95% CI -0.72 to +1.94 and -0.81 to +0.44); p = 0.45 and p = 0.82, respectively). Furthermore, 4 weeks of therapeutic CPAP did not significantly change levels of adiponectin in plasma compared with the subtherapeutic control group (difference between median changes +0.05 pg/ml (95% CI -0.36 to +0.47); p = 0.84). If patients with hsCRP values above 8 mg/l at baseline were excluded, differences between the changes in hsCRP, IL6, IFN gamma and adiponectin after 4 weeks of CPAP were smaller, and again not statistically different between groups.Conclusions: 4 weeks of CPAP treatment has no beneficial effect on blood markers of inflammation and adiponectin in patients with moderate-severe obstructive sleep apnoea.