Study On The Blood Hypercoagulability In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To investigate the blood hypercoagulability in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).This study focus on the variation tendency of hypercoagulability in patients' blood.By measuring the changes of Endothelial cell protein C receptor(EPCR),D-dimer,Red blood cell specific volume(HCT)in Peripheral blood,we explored the reason and clinical significance of the changes of coagulation functions induced by OSAHS.We further investigated whether nasal continuous positive airway pressure(nCPAP)could affect hypercoagulability in patients' blood.Methods: 65 patients were diagnosed as OSAHS by polysomnography,These patients were divided into two groups,25 mild OSAHS patients as group A,40 moderate or severe OSAHS patients as group B,another 25 healthy patients were selected as control group.There were no significant differences in age,sex and body mass index between these groups.HCT,D-Dimer and EPCR were measured in all cases.The expression of EPCR protein and mRNA expression were detected by enzyme-linked immunosorbent assay(ELISA)and RT-PCR.HCT,D-Dimer,EPCR were compared among patients of three groups.The correlation among HCT,D-dimer,EPCR and apnea hypopnea index(AHI),nighttime mean pulse oximetry(MSa02),and nighttime minimum pulse oximetry(LSa02)were analyzed.Patients with moderate or severe OSAHS were treated with nCPAP,and changes of EPCR before and after treatment were detected.Results: There was no significant difference in HCT between group A and group B(P> 0.05).There was no significant difference in D-dimer and EPCR between group A and C(P> 0.05).There were significant differences in D-dimer and EPCR between group B and group C(P <0.05).Promote thrombosis factors HCT,D-dimer and EPCR were positively correlated with AHI and negatively correlated with MSa02 and LSa02.There were significant differences in the changes of serum D-dimer and EPCR levels in patients with moderate and severe OSAHS after nCPAP treatment.Conclusions: Our study demonstrated that Patients diagnosed as moderate or severe OSAHS had blood hypercoagulability,which were associated with D-dimer and EPCR levels.Moderate or severe OSAHS patients who were complicated with thrombotic disease were associated with hypoxia and AHI.nCPAP treatment can reduce blood hypercoagulability in OSAHS patients.