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| 阻塞性睡眠呼吸暂停综合征患者的血浆同型半胱氨酸与左室几何构型的相关性临床研究 |
| 冯晓丽,王健,水雯,张勇,田云,康彩虹,崔桐 |
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| (山西医科大学第一医院超声科) |
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| 摘要: |
| 目的 探讨血浆同型半胱氨酸(Hcy)对阻塞性睡眠呼吸暂停综合征(OSAS)患者左室几何构型改变的影响。方法 选取经多导睡眠呼吸仪(PSG)监测呼吸暂停指数(AHI)≥5次/h确诊为OSAS的患者192例,次日晨行血压、血糖、血脂、血浆同型半胱氨酸水平测定及超声心动图检查,同时选取性别、年龄匹配,血糖、血脂、胸片、心电图和PSG等检查均正常的健康人30例作为对照组。依据左室质量指数(LVMI)和相对室壁厚度(RWT)将OSAS患者按左室几何构型分为四组：正常构型组(NG)、向心性重构组(CR)、向心性肥厚组(CH)、离心性肥厚组(EH)。比较对照组与OSAS四组血浆Hcy水平的差异,对血浆Hcy与其他参数进行单因素相关性分析,并进一步进行多因素逐步回归分析。 结果 ①与对照组相比,CR组、CH组、EH组血浆Hcy水平升高,差异具有统计学意义(P<0.05)；与NG、CR组相比,CH组、EH组血浆Hcy水平升高,差异具有统计学意义(P<0.05)；与EH组相比,CH组血浆Hcy水平升高,差异无统计学意义(P>0.05)；②单因素相关性分析血浆Hcy与BMI、SBP、腹围、AHI、血糖、LVMI、异常左室几何构型呈正相关,与Em/Am、LVEF呈负相关,而与性别、年龄、DBP、颈围、臀围、T90、MSaO2、LSaO2、RWT无相关性 ；③多因素逐步线性回归进一步分析得出血浆Hcy与AHI、LVMI、异常左室几何构型独立相关。结论 OSAS不同左室几何构型患者的血浆Hcy表达水平不同,血浆Hcy水平是OSAS患者左室几何构型(CH、EH)改变的主要影响因素之一。 |
| 关键词: 阻塞性睡眠呼吸暂停综合征 血浆同型半胱氨酸 左室几何构型 |
| DOI： |
| 投稿时间：2021-01-14修订日期：2021-08-30 |
| 基金项目: |
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| Clinical study on the correlation between plasma homocysteine and left ventricular geometry in patients with obstructive sleep apnea syndromeScreening for Depression FENG Xiao-li,WANG Jian,SHUI Wen,ZHANG Yong,TIAN Yun,KANG Cai-hong,CUI Tong,The First Hospital of Shanxi Medical University,Taiyuan 030000,China |
| fengxiaoli,wangjian,shuiwen,zhangyong,tianyun,kangcaihong,cuitong |
| (shanxiyikedaxuediyiyiyuan) |
| Abstract: |
| Objective To investigate the effect of plasma homocysteine(Hcy) on the changes of left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS). Methods A total of 192 patients with OSAS diagnosed with apnea index (AHI)≥5times/h by polysomnography (PSG) were selected. Blood pressure, blood glucose, blood lipids, and plasma homocysteine levels were measured the next morning. For echocardiography, 30 healthy people whose gender, age match, blood glucose, blood lipids, chest radiograph, electrocardiogram and PSG were normal were selected as the control group. According to the left ventricular mass index (LVMI) and relative wall thickness (RWT), OSAS patients are divided into four groups according to the geometric configuration of the left ventricle: normal configuration group (NG), concentric remodeling group (CR), and concentric hypertrophy Group (CH), eccentric hypertrophy group (EH). The difference of plasma Hcy levels between the control group and the OSAS four groups was compared, and the single-factor correlation analysis between plasma Hcy and other parameters was performed, and the multivariate stepwise regression analysis was further performed. Results ① Compared with the control group, the plasma Hcy levels of the CR, CH, and EH groups increased, and the difference was statistically significant (P<0.05); compared with the NG and CR groups, the plasma Hcy levels of the CH and EH groups increased High, the difference was statistically significant (P<0.05); Compared with the EH group, the plasma Hcy level in the CH group increased, and the difference was not statistically significant (P>0.05); ② Univariate correlation analysis of plasma Hcy and BMI, SBP , Abdominal circumference, AHI, blood glucose, LVMI, abnormal left ventricular geometric configuration are positively correlated, and are negatively correlated with Em/Am, LVEF, and are correlated with gender, age, DBP, neck circumference, hip circumference, T90, MSaO2, LSaO2, RWT No correlation; ③Further analysis of multivariate stepwise linear regression showed that plasma Hcy was independently related to AHI, LVMI, and abnormal left ventricular geometry. Conclusion The expression levels of plasma Hcy in patients with different left ventricular geometric configurations of OSAS are different. The level of plasma Hcy is one of the main influencing factors of changes in left ventricular geometric configuration (CH, EH) in patients with OSAS. |
| Key words: Obstructive sleep apnea syndrome Pasma homocysteine Left ventricular geometry |
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