Obstrüktif Uyku Apne Sendromu (OUAS) Saptanan Hastalarda Vasküler Fonksiyon Bozukluğu ve Ateroskleroz Riskinin Değerlendirilmesi
Amaç: Obstrüktif Uyku Apne Sendromu (OUAS) saptanan hastalarda vasküler endoteliyel işlev bozukluğu ve preaterosklerozis;brakial arter akım aracılı vazodilatasyon (BAAV), karotis arter intima-media kalınlığı (KIMK), mean platelet volume (MPV) veepikardiyal yağ dokusu (EYD) ölçümü yapılarak değerlendirildi. OUAS hastaları Apne-hipopne indekslerine (AHI) göre gruplaraayrılarak kıyaslandı.Hastalar ve Yöntem:Hastanemize uyku bozukluğu nedeni ile başvuran ve polisomniografi ile yapılan değerlendirmede AHİ değeri5 ve üstünde bulunan, hiperlipidemi, hipertansiyon, diyabetes mellitus ve bilinen kalp-damar hastalığı olmayan, yaşları 30-70arası, kadın ve erkeklerden oluşan hastalar çalışmaya dahil edildi. Bu hastalar AHI derecelerine göre hafif-orta ve şiddetli şeklindegruplandırıldı. Preateroskleroz KIMK, EYD kalınlığı ve MPV ile vasküler fonksiyon ve endotel hücre vazodilatasyonu ise BAEF bakılarak değerlendirildi. İstatistik olarak iki grup arasındaki farklılıklar değerlendirilmek istendiğinde parametrik test ön şartlarınısağladığı durumda “Student’s t Test”; sağlamadığında ise “Mann Whitney–U testi” kullanıldı.Bulgular: 23 hastanın 16 tanesi erkek, 7 tanesi kadındır. Yaş ortalaması 46,30+9,51 (31-65 yaş arası). Hastalar AHI indekslerinegöre (hafif:5-15, orta:16-30, şiddetli >30) olarak gruplandırıldığında karşılaştırma için kullanılan parametrelerde anlamlı farklılık saptanmadı.Sonuç: OUAS hastalarında kardiyovasküler riskin arttığı bilinmektedir. Çalışmamızda bu hastalarda hastalığın şiddeti ile preateroskleroz ve endotel fonksiyonun bozulması arasında bağlantı bulunmamıştır.
INVESTIGATION OF ENDOTHELIAL DYSFUNCTION AND THE RISK OF ATHEROSCLEROSIS IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
Purpose: To investigate endothelial dysfunction and pre-atherosclerosis in patients with Obstructive Sleep Apnea Syndrome (OSAS) by using several parameters including Brachial Artery Flow-Mediated Vasodilation (BAFMV), Carotid Intima-Media Thickness (CIMT), Mean Platelet Volume (MPV) and Epicardial Fat Thickness (EFT). Patients with OSAS were classified according to the Apnea-Hypopnea Index (AHI). Patients and Methods: OSAS patients who have 5 or more AHI score were enrolled in the study. Patients with hypertension, hyperlipidemia, diabetes mellitus and cardiovascular diseases were excluded. Patients were classified as mild (5-10), moderate (16-30) and severe (>30) according to AHI. These groups were compared to each other in terms of endothelial dysfunction and pre-atherosclerosis markers including BAFMV, CIMT, MPV and EFT. Groups were compared statistically by using either Student’s T-Test or Mann Whitney–U test. Results: Our study population consists of 23 patients with OSAS (16 male, 7 female) with the mean age of 46.30±9.51 years ranging from 31-65 years. There were no significant differences in all parameters between the mild (5-10), moderate (16-30) and severe (>30) groups according to AHI. Conclusion: It is well known that patients with OSAS have an increased cardiovascular risk. In our study, no differences were shown between the progression of the disease and endothelial dysfunction and pre-atherosclerosis markers.
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