Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability.
Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability.
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DOI：
10.5551/jat.2188
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发表时间：
2009
影响因子：
4.4
通讯作者：
T. Oga;K. Chin;A. Tabuchi;Mitsunori Kawato;T. Morimoto;Ken‐ichi Takahashi;T. Handa;Kanako Takahashi;R. Taniguchi;H. Kondo;M. Mishima;T. Kita;H. Horiuchi
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文献类型：
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作者：
T. Oga;K. Chin;A. Tabuchi;Mitsunori Kawato;T. Morimoto;Ken‐ichi Takahashi;T. Handa;Kanako Takahashi;R. Taniguchi;H. Kondo;M. Mishima;T. Kita;H. Horiuchi
目的：阻塞性睡眠呼吸暂停（OSA）是心血管疾病的危险因素。血小板在动脉粥样硬化血栓形成中起关键作用。一些评估OSA患者血小板活化的研究已经发表；然而，仅有少数OSA患者的血小板聚集性研究，血小板聚集性比血小板激活状态更直接地评估血小板聚集性。我们的目的是研究OSA和鼻腔持续气道正压通气（nCPAP）治疗对血小板聚集性的影响，nCPAP是一种公认的OSA治疗方法。方法与结果我们研究了124例连续打鼾患者，分析了其中3%氧去饱和指数（3% odi）， OSA严重程度的标志，以及用光学聚集仪测量的ADP和胶原诱导的血小板聚集性。adp诱导的血小板聚集性在中度至重度OSA患者中（3%ODI bbb15）高于非至轻度OSA患者（p=0.029）。在多元线性模型中，3%ODI显著促进了59名有吸烟、高血压、糖尿病或高脂血症等血管疾病危险因素的受试者中ADP和胶原诱导的血小板聚集性的增加。在接受nCPAP治疗的23例患者中，与基线相比，胶原诱导的血小板聚集性在第90天得到改善。结论OSA严重程度显著影响血小板聚集性，nCPAP治疗可在3个月时部分改善血小板聚集性。
AIM Obstructive sleep apnea (OSA) is a risk factor for cardiovascular diseases. Platelets play key roles in the development of atherothrombosis. Several studies assessing platelet activation in patients with OSA have been published; however, there have been only a few studies with a small number of patients with OSA investigating platelet aggregability, which evaluates platelet aggregation more directly than the platelet activation status. We aimed to investigate the effects of OSA and nasal continuous positive airway pressure (nCPAP) therapy, a well-established treatment for OSA, on platelet aggregability. METHODS AND RESULTS We examined 124 consecutive patients with snoring in whom the 3% oxygen desaturation index (3%ODI), a severity marker of OSA, and ADP- and collagen-induced platelet aggregability measured with the optical aggregometer were analyzed. ADP-induced platelet aggre-gability was increased more in patients with moderate-to-severe OSA (3%ODI>15) than in patients with non-to-mild OSA (p=0.029). In multiple linear models, 3%ODI significantly contributed to increased platelet aggregability induced by both ADP and collagen among 59 subjects with one or more risk factors for vascular diseases, such as smoking, hypertension, diabetes mellitus or hyperlipidemia. In 23 patients treated by nCPAP, collagen-induced platelet aggregability was ameliorated on Day 90, compared to at the baseline. CONCLUSION The severity of OSA significantly contributed to platelet aggregability, which was improved by nCPAP treatment partially at three months.