QTc Dispersion, Cardiac Sympathetic Functionand Secretion of Leptin in Patients with Obstructive Sleep Apnea.

低氧血症可增加校正QT离散度（QTcD），这是心血管死亡的一个强风险因素。48例连续OSAHS患者[平均年龄45.9岁，呼吸暂停低通气指数（AHI）51.9/h，动脉血氧饱和度低于90%（SaO 2 <90%）的时间百分比28.7%]在nCPAP治疗第一晚后睡眠时QTc离散度显著降低（p<0.0001）。治疗前睡眠时QTcD与AHI（p=0.009）和SaO 2 <90%时间（p= 0.001）相关。QTcD与碘-123-间碘苄胍（MIBG）心脏显像的洗脱率无关。OSAHS患者的夜间QTcD增加，但nCPAP治疗可降低夜间QTcD，与心脏交感神经功能无关。nCPAP治疗第一晚显着降低了21例AHI 52.4/h的OSAHS患者的血浆瘦素水平（p<0.02）。nCPAP治疗后OSAHS患者瘦素水平下降的幅度与心脏交感神经功能显著相关。 ...更多信息 在nCPAP治疗前通过MIBG血管造影术测量的动脉压（p<0.03）。OSAHS患者经nCPAP治疗第一夜后血浆瘦素水平明显下降。在40例肥胖男性OSAHS患者中，分别于nCPAP治疗前、治疗后及治疗后的下午和清晨测定血清AST和ALT水平。35%的患者转氨酶水平异常。治疗前，上午的AST水平高于前一天下午（p=0.006）。在nCPAP治疗的第一个晚上后，早晨空腹AST和ALT水平的升高显著改善（AST，P=0.0003; ALT，p=0.006）。在nCPAP治疗1个月和6个月后，AST和ALT水平的改善得以维持。OSAHS对肝功能有明显影响。nCPAP治疗应被视为肥胖和转氨酶异常伴阻塞性睡眠呼吸暂停患者的新策略。少

Hypoxemia increases corrected QT dispersion (QTcD), which is a strong risk factor for cardiovascular mortality. QTc dispersion during sleep in 48 consecutive OSAHS patients [mean age: 45.9, apnea & hypopnea index (AHI) :51.9/h, the percentage of time that arterial O2 saturation below 90% (SaO2<90%): 28.7%] during sleep decreased significantly after first night of nCPAP therapy (p<0.0001). Before tratment, the QTcD during sleep correlated with the AHI (p=0.009) and SaO2<90% time (p= ). The QTcD did not correlate with the washout rate of iodine-l23-metaiodobenzylguanidine (MIBG) cardiac imaging. Nocturnal QTcD is increased in OSAHS patients but is decreased by nCPAP therapy independently of cardiac sympathetic function.The first night of nCPAP treatment significantly decreased the plasma leptin levels (p<0.02) in 21 OSAHS patients with AHI 52.4/h. The magnitude of decreases in leptin levels in OSAHS patients after nCPAP treatment were significantly correlated with cardiac sympathetic fun … More ction as measured by MIBG scintigraphy before nCPAP treatment (p<0.03). Plasma leptin levels in OSAHS patients decreased significantly after the first night of nCPAP treatment. Enhanced cardiac sympathetic function in OSAHS patients may contribute to the leptin levels before nCPAP treatment and vice versa.In 40 obese men with OSAHS, AST and ALT levels were determined in the afternoon and the morning immediately after sleep, before and after nCPAP treatment. Aminotransferase levels were abnormal in 35% of patients. Before treatment, AST levels were higher in the morning than the previous afternoon (p=0.006). The increase in morning fasting AST and ALT levels improved with significance after the first night of nCPAP treatment (AST, P=0.0003; ALT, p=0.006) Improvement of AST and ALT levels was maintained after 1 and 6 months of nCPAP treatment. OSAHS had significant effects on liver function. nCPAP therapy should be considered as a new strategy for patients with obesity and aminotransferase abnormalities who have obstructive sleep apnea. Less