Significance Of The Changes In Plasma Levels Of α-granule Membrane Protein,Platelets Glycoprotein Ⅱb/Ⅲa Complex And D-dimer In The Patients With Obstractive Sleep Apnea Syndrome

Objective: Obstractive sleep apnea syndrom(OSAS) is a common health problem with potential risk that has become an independment risk factor for unstable angina,myocardial infarction and brain infraction,so it is necessary to investigate the main death factor-trie high prevalence of cerebrovascular and cardiovascular events in patients with OS AS. The cause of increased cerebrovascular and cardiovascular morbidity and mortality in patients with OSAS is not clear. It have been suggested that plate activation and enhance coagulability, fibrinolytic activa-tion may contribute to the pathogenesis of this condition. Whether plate activation and enhance coagulability, fibrinolytic activa-tion occur and play a role in prevalence of cerebrovascular and cardiovascular events in patients with OSAS is unknown .By measuring changes of Plasma levels of GMP-140, GP lib/III a and D-dimer in patients with OSAS before and after the institution of nasal continuous positive airway pressure (nCPAP), we want to study whether plate activation and enhance coagulability, fibrinolytic activation occur and play a role in prevalence ofcerebrovascular and cardiovascular events in patients with OSAS and the association with hypoxemia, if so, whether therapy with nCPAP alters this effect.Methods: 58 cases diagnosed as OSAS by polysomnography(PSG)were selected as trial group, 20 cases exclude from OSAS by PSG were as control group, and 11 severe OSAS patients were treated by nCPAP and taken as nCPAP therapy group.GMP-140, GPlIb/IIIa and D-dimer were measured by ELISA and compared in these groups.Results: 1. In mild OSAS group, the Plasma levels of GMP-140, GPlIb, GPIIIa and D-dimer were (14.77 ?2.36)ng/ml, 37859.62+1832.52, 48461.44 + 2368.93, (0.29 + 0.05)mg/l respectively. In control group, the values were (14.66+1.72)ng/mK37612.65 + 568.76>48457.20+1486.5K (0.28 + 0.04)mg/l respectively, there were no statistic significant differences. 2. In moderate OSAS group, the value were (16.38 + 2.64)ng/mK 38251.77 +860.85 > 49588.94 + 955.80 ^ (0.32 + 0.04)mg/l respectively, which were significantly higher than that in control group(/><0.05). 3. the Plasma levels of GMP-140, GPII b, GPIIIa and D-dimer were significant higher in severe OSAS group (18.34 + 3.27)ng/mK 39508.48 +1283.60> 50911.48 + 2399.42, (0.45 + 0.05)mg/l than that in control group( PO.01), and in nCPAP therapy group after therapy significantly lower than that before nCPAP therapy(P<0.001). 4. GMP-140, GPIIK GPIIIa and D-dimer were correlated significantly and positively with AHI(r=0.5199, 0.4761, 0.4471, 0.7818, PO.001) and negatively with minimal oxygen saturation(r=-0.6728 -0.5736-0.6123, -0.7629, PO.001).Conclusion: 1. Our findings suggest that activation of platelet and coagulation system combined with fibrinolytic activation occur and may play an important role in the high prevalence of cerebrovascular and cardiovascular events in patients with moderate and severe OSAS. 2. There are a association between activation of platelet and coagulation system combined with fibrinolytic activation in patients with OSAS and hypoxemia, This effect is greatly reduced by nCPAP.