Changes in coagulation and fibrinogenolysis (factor VII clotting activity and type 1 plasminogen activator inhibitor) in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy.

阻塞性睡眠呼吸暂停综合征患者经鼻持续气道正压通气治疗后凝血和纤维蛋白原溶解（VII 因子凝血活性和 1 型纤溶酶原激活剂抑制剂）的变化。

• 批准号: 09670608
• 负责人: CHIN Kazuo
• 金额: $ 0.64万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09670608/
• 关键词: obstructive sleep apnea syndrome; obesity; leptin; coagulation; visceral fat nasal; CPAP; factor VII clotting activity; cardiovascular diseases; 内臓脂肪症候群; リスクファクター; OSAS; 経鼻持続気道陽圧; nCPAP; 凝固7因子活性; 睡眠呼吸障害; 脳・心血管傷害; NCPAP; 内蔵脂肪; 凝固線溶系

Factor VII clotting activity (FVIIc) which is an independent risk factor for ischemic heart disease, was investigated prospectively in 15 patients with obstructive sleep apnea syndrome (OSAS) before apnea and hypopnea index (AHI) 62±4 (mean±SEM) and after (AHI 3±1) nasal continuous positive airway pressure (nCPAP) treatment for immediate relief, at 1 month after treatment and at over 6 months. FVIIc levels gradually decreased after nCPAP treatment. After 6 months of nCPAP treatment, FVIIc levels had decreased significantly (before 141±12% vs. after 6 months 111±6%;p<0.01). This decrease in FVIIc after long-term nCPAP treatment could improve mortality in OSAS patients.Visceral fat accumulation (VFA) which is a better predictor of coronary heart disease, and subcutaneous fat accumulation (SFA) were assessed by computed tomography before and after nCPAP treatment in 22 OSAS patients (mean AHI>50). Serum leptin levels of another 21 OSAS patients were measured before and after 3-4 days of nCPAP to gain insight into the mechanism by which nCPAP affects fat distribution. VFA and SFA decreased significantly after 6 months of nCPAP treatment (VFA: from236±16 to 182±14cmィイD12ィエD1, p=0.0003;SFA: from 215±21 to 189±18 cmィイD12ィエD1, p=0.003). The VFA decreased significantly in the body weight reduction (BWR) group (n=9, p<0.01) and No-BWR group (n=13, p<0.03). In contrast, SFA changed significantly in the BWR group only (p<0.01). Leptin levels decreased significantly following 3-4 days of nCPAP (p<0.01), while body weight, fasting insulin or cortisol levels did not change significantly. Correcting of sleep disordered breathing by nCPAP may be used to reduce VFA in OSAS patients. OSAS may have significant effects on the serumleptin levels.

对15例阻塞性睡眠呼吸暂停综合征（OSAS）患者进行了前瞻性研究，观察其呼吸暂停低通气指数（AHI）为62±4（平均值±SEM）、经鼻持续气道正压通气（nCPAP）治疗后即刻、治疗后1个月及6个月以上的凝血因子VII活性（FVIIc）。nCPAP治疗后FVIIc水平逐渐降低。nCPAP治疗6个月后，FVIIc水平显著降低（治疗前141±12% vs. 6个月后111±6%;p<0.01）。对22例OSAS患者（平均AHI>50）进行nCPAP治疗前后的内脏脂肪蓄积（VFA）和皮下脂肪蓄积（SFA）的CT检查，并与对照组比较。另外21例OSAS患者在nCPAP治疗前和治疗后3-4 d测定血清瘦素水平，以了解nCPAP影响脂肪分布的机制。nCPAP治疗6个月后，VFA和SFA显著降低（VFA：从236 ±16至182± 14 cm P2P D12，p=0.0003;SFA：从215±21至189±18 cm P2P D12，p=0.003）。VFA在体重减轻组（n=9，p<0.01）和无体重减轻组（n=13，p<0.03）中显著降低。相反，SFA仅在BWR组中显著改变（p<0.01）。nCPAP治疗3-4天后，瘦素水平显著降低（p<0.01），而体重、空腹胰岛素或皮质醇水平无显著变化。nCPAP纠正睡眠呼吸障碍可降低OSAS患者VFA。OSAS对血清瘦素水平有显著影响。

项目成果

Kita H,Ohi M,Chin K,et al.: "The nocturnal sccretion of cardiac natriuretic peptides during obstructive sleep apnoea and its response to therapy with nasal continuous positive airway pressure." Journal of Sleep Research. 7. 199-207 (1998)

Kita H、Ohi M、Chin K 等人：“阻塞性睡眠呼吸暂停期间心钠肽的夜间分泌及其对鼻持续气道正压治疗的反应。”

陳 和夫、他: "肥満と閉塞性睡眠時無呼吸症候群.シンポジウムIII 肥満と疾患." 日本内科学会誌. 87. 1793-1796 (1998)

Kazuo Chen 等人：“肥胖和阻塞性睡眠呼吸暂停综合征。研讨会 III 肥胖与疾病。”日本内科学会杂志 87。1793-1796 (1998)

Chin K, et al.: "Problems and recent advances in the understanding of obstructive sleep apnea syndrome."The Journal of the Japanese Respiratory Society. 37. 169-176 (1999)

Chin K 等人：“理解阻​​塞性睡眠呼吸暂停综合征的问题和最新进展。”日本呼吸学会杂志。

Chin K,et al.: "Deep breathing and awake apnoea in a patient who had recurrent hypoxacmia and hypercapnia whithout sleep apnoca." European Respiratory Journal. 12. 739-741 (1998)

Chin K 等人：“一位患有反复性低氧血症和高碳酸血症但没有睡眠呼吸暂停的患者出现深呼吸和清醒呼吸暂停。”

Chin K ,et al.: "Improvement of factor VIIclotting activity following long term NCPAP treatment in obstructive sleep apnoea syndrome"Quarterly Journal of Medicine. 91. 627-633 (1998)

Chin K 等人：“阻塞性睡眠呼吸暂停综合征长期 NCPAP 治疗后 VII 因子凝血活性的改善”医学季刊。