Obstrüktif uyku apne sendromlu hastalarda fibrinojen düzeylerinin değerlendirilmesi
Loading...
Files
Date
2009
Authors
Demirdöğen, Ezgi
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Obstrüktif uyku apne sendromu (OUAS); uyku boyunca tekrarlayan üst solunum yolu obstrüksiyonu ile karakterize, intermittant arteriyel oksijen desaturasyonu ve solunum eforunda artışla ilişkili bir sendromdur. OUAS hastalarında vasküler hastalık riski artmıştır. OUAS'lı hastalarda kardiyovasküler hastalık gelişimine ait kesin mekanizma bilinmemektedir. Fibrinojen normal plazmanın ana bileşenidir. Akut faz reaktanıdır ve fibrinojen düzeyleri inflamatuar yanıtın bir parçası olarak yükselir. Fibrinojenin koroner arter hastalığı ve inme için bağımsız risk faktörü olduğu gösterilmiştir.Bu çalışmada amacımız, OUAS ve kontrol grubunda plazma fibrinojen düzeylerini karşılaştırmaktı.Yeni tanı almış 50 orta ve ağır OUAS olgusu ile 33 nonapneik kontrol olgu çalışmaya alındı. Tüm hastalara tam polisomnografi yapıldı. Kan örnekleri, uyku çalışmasının ardından sabah 8.00-9.00 saatleri arasında alındı. Fibrinojen düzeyleri Clauss metodu ile ölçüldü (multifibren U kiti ile). Her iki grup arasında yaş, cinsiyet, sigara alışkanlığı açısından fark yoktu. Plazma fibrinojen düzeyleri OUAS grubunda (4.2 ? 0.14 g/L) kontrol grubuna göre anlamlı derecede yüksek bulundu (p<0.028). Plazma fibrinojen düzeyleri; Epworth uykululuk skalası (ESS) (r=0.301, p=0.006), yaş (r=0.327, p=0.003), beden kitle indeksi (BKİ) (r=0.388, p<0.001), ortalama oksijen desaturasyonu (r=0.258, p=0.019), oksijen desaturasyon indeksi (r=0.281, p=0.010), oksijen satürasyonunun % 90'ın altında kalma süresi (r=0.248, p=0.024) ve arousal indeksi (r=0.220, p=0.046) ile pozitif korele idi. Plazma fibrinojen düzeyleri ile uykudaki oksijen saturasyonu arasında (r= -0.254, p=0.029) negatif korelasyon mevcuttu. Çoklu doğrusal regresyon analiz ile ESS ve BKİ'nin plazma fibrinojen yüksekliği için AHİ'den bağımsız risk faktörü olduğu saptandı.Bu çalışma sonucunda plazma fibrinojen düzeyleri ile ESS ve BKİ'nin korele olduğu belirtilmiştir. Fibrinojen düzeyleri ve nokturnal desaturasyon arasındaki ilişki hipoksi inflamasyon ilişkisini desteklemektedir. Fibrinojenin OUAS'lı hastalarda vasküler hastalık gelişimi için önemli bir faktör olabileceği sonucuna vardık.
Obstructive sleep apnea syndrome (OSAS) is a syndrome characterised by repeated episodes of upper airway obstruction during sleep, associated with increasing respiratory efforts, intermittent arterial oxygen desaturation. Risk of vascular disorders is increased at OSAS patients. The exact mechanism of development of vascular disease in patients with OSAS remains to be unknown. Fibrinogen is a major constituent of normal plasma. Fibrinogen is an acute phase reactant, with increasing levels as part of the of the acute inflammatory response. Fibrinogen has been shown to be an independent risk factor for coroner heart disease and stroke.Our aim was to study to compare plasma fibrinogen levels between OSAS and control groups.Fifty patients with newly diagnosed moderate and severe OSAS and 33 nonapneic control subjects were enrolled in this study. Full polysomnography was performed in all patients. Blood samples were drawn between 8:00 AM and 9:00 AM after the sleep study. Fibrinogen levels were analyzed with Clauss method (Multifibren U kit). There were no significant differences in age, gender, smoking habit between the two groups. Plasma fibrinogen levels in the OSAS group (4.2 ? 0.14 g/L) were significantly higher than that in the control group (p<0.028). Plasma fibrinogen levels were positively correlated with Epworth sleepiness scale (ESS) (r=0.301, p=0.006), age (r=0.327, p=0.003), body mass index (BMI) (r=0.388, p<0.001), average oxygen desaturation (r=0.258, p=0.019), oxygen desaturation index (r=0.281, p=0.010) , length of time spent with an oxygen saturation <90% (r=0.248, p=0.024) and arousal index (r=0.220, p=0.046). Plasma fibrinogen levels were negatively correlated with average oxygen saturation during sleep (r= -0.254, p=0.029). Multipl linear regression analyses showed that high ESS and body mass index were a risk factor elevated plasma fibrinogen levels, independent of apne hipopne index.In conclusion we suggest that plasma fibrinogen levels correlate with BMI and ESS. The association between plasma fibrinogen levels and nocturnal desaturation supports the linkage between hypoxia and inflamation. We conclude that fibrinogen may be an important factor for development of vascular disease in patients with OSAS.
Obstructive sleep apnea syndrome (OSAS) is a syndrome characterised by repeated episodes of upper airway obstruction during sleep, associated with increasing respiratory efforts, intermittent arterial oxygen desaturation. Risk of vascular disorders is increased at OSAS patients. The exact mechanism of development of vascular disease in patients with OSAS remains to be unknown. Fibrinogen is a major constituent of normal plasma. Fibrinogen is an acute phase reactant, with increasing levels as part of the of the acute inflammatory response. Fibrinogen has been shown to be an independent risk factor for coroner heart disease and stroke.Our aim was to study to compare plasma fibrinogen levels between OSAS and control groups.Fifty patients with newly diagnosed moderate and severe OSAS and 33 nonapneic control subjects were enrolled in this study. Full polysomnography was performed in all patients. Blood samples were drawn between 8:00 AM and 9:00 AM after the sleep study. Fibrinogen levels were analyzed with Clauss method (Multifibren U kit). There were no significant differences in age, gender, smoking habit between the two groups. Plasma fibrinogen levels in the OSAS group (4.2 ? 0.14 g/L) were significantly higher than that in the control group (p<0.028). Plasma fibrinogen levels were positively correlated with Epworth sleepiness scale (ESS) (r=0.301, p=0.006), age (r=0.327, p=0.003), body mass index (BMI) (r=0.388, p<0.001), average oxygen desaturation (r=0.258, p=0.019), oxygen desaturation index (r=0.281, p=0.010) , length of time spent with an oxygen saturation <90% (r=0.248, p=0.024) and arousal index (r=0.220, p=0.046). Plasma fibrinogen levels were negatively correlated with average oxygen saturation during sleep (r= -0.254, p=0.029). Multipl linear regression analyses showed that high ESS and body mass index were a risk factor elevated plasma fibrinogen levels, independent of apne hipopne index.In conclusion we suggest that plasma fibrinogen levels correlate with BMI and ESS. The association between plasma fibrinogen levels and nocturnal desaturation supports the linkage between hypoxia and inflamation. We conclude that fibrinogen may be an important factor for development of vascular disease in patients with OSAS.
Description
Keywords
Fibrinojen, Obstrüktif uyku apne sendromu (OUAS), Epworth uykululuk skalası (ESS), Fibrinogen, Obstructive sleep apnea syndrome (OSAS), Epworth sleepiness scale (ESS), Hipoksi, Vasküler hastalık, Hypoxia, Vasculer disease
Citation
Demirdöğen, E. (2009). Obstrüktif uyku apne sendromlu hastalarda fibrinojen düzeylerinin değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.