UPPP手术对阻塞性睡眠呼吸暂停低通综合症患者血清hs-CRP的影响
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摘要
目的:探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep ApneaHypopnea Syndrom,OSAHS)患者超敏C-反应蛋白(high sensitive C-creativeprotein,hs-CRP)的变化及肥胖对于这种变化的影响,同时探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对OSAHS患者血清超敏C-反应蛋白的变化的影响。
方法:选择经过我院多导睡眠图检查并根据中华医学会耳鼻咽喉分会2002年杭州会议标准确诊的20例适合行UPPP手术的OSAHS患者做为实验组,同时选取20例单纯肥胖的病人及20例健康人作为两个对照组,进行对照研究。实验血术前空腹取肘静脉血3 ml,采用免疫比浊法测定血清中的超敏C-反应蛋白,常规测量体重、身高,术后三个月再次复查PSG监测及血清C-反应蛋白的水平。
结果:1、OSAHS组和单纯肥胖组除体重指数(BMI Body Mass Index)值无明显差异(p＞0.5)外,hs-CRP及睡眠监测各项参数包括呼吸暂停低通气指数(AHI apnea hypopnea index)、夜间最低SaO_2及平均SaO_2均有明显差异(P＜0.05),而单纯肥胖组和正常组之间在BMI值和hs-CRP上的差异具有明显的统计学意义(P＜0.05),OSAHS组和正常组的hs-CRP、BMI、AHI、夜间最低SaO_2及平均SaO_2差异均有统计学意义(P＜0.05);OSAHS组的hs-CRP值与AHI之间存在明显正相关性(t=0.485,P＜0.05);hs-CRP值与平均SaO_2存在负相关性(t=-0.506,P＜0.05)。
2、UPPP手术术后三个月80%的患者自觉症状改善,检查见所有OSAHS患者的咽腔狭窄情况明显好转,未出现咽部明显的局部炎症反应。术后的hs-CRP值明显低于术后(r=4.818,P＜0.001),术后三个月患者的AHI值出现明显的下降(r=10.01,P＜0.001),夜间最低SaO_2及平均SaO_2均出现明显的提高。18例患者术后的AHI值较术前降低了60%以上,其中有16例患者的CRP值术后降低了40%以上,2例患者术后的的CRP值未见降低,反而有所升高。2例患者的AHI值仅降低12%和9%,其术后的hs-CRP值也未发生明显的变化。
结论:1、OSAHS患者及单纯肥胖者的血清hs-CRP含量都明显高于正常者,而C-反应蛋白(C-reactive protein,CRP)是目前最有价值的急性时相反应蛋白,可以说明肥胖患者的hs-CRP的水平增高可能与肥胖本身处于慢性炎症状态有关。同时也提示OSAHS组hs-CRP水平的提高可能与呼吸暂停及上呼吸道的炎症有关。
2、OSAHS患者行UPPP手术后血清中的hs-CRP水平含量明显下降,说明UPPP手术可以通过解除部分上呼吸道阻塞而改善上气道的夜间低氧状态和睡眠质量,炎症反应迅速减轻,UPPP除了降低AHI的同时可能可以通过局部的机制影响炎症,UPPP手术是一种治疗OSAHS患者有效的手术方法之一,可以大大降低OSAHS患者心血管疾病的发生率和死亡率。
Objective:To explore the changes of the serum high sensitive C-creative protein level in patientse who have been diagnosised as OSAHS and the effect of fatness on this change.Meanwhile we will explore the effects of uvulopalatopharyngoplasty(UPPP)on high sensitive C-creative protein(hs-CRP)in serum of patients with obstructive sleep apnea hypopnea syndrome(OSAHS).
Method:We chose twenty patients as the experimental group who have been diagnosised as OSAHS and must be operated by UPPP after monitored by PSG in my hospital.Meanwhile we aslo chose twenty fat people without any other disease and twenty healthy people as two control groups.We compared these three groups in all index.The concentration of serum high sensitive C-creative protein(hs-CRP)level were measured with ELISA in the experimental group(n=20)and two control groups. The vein blood must be extracted before breaskfast in the morning.Three months after operation,OSAHS patients were monitored by PSG and serum high sensitive C-creative protein(hs-CRP)level were measured again.
Result:1.BMI of The OSAHS group and that of the fatness group hsve no significant difference(P＞0.5).But other index have significant difference (P＜0.05).BMI and C-creative protein(hs-CRP)level of the fatness group and that of the healthy have significant difference(P＜0.05).The OSAHS group and the healthy have significant difference in all index(P＜0.05).Before treatment,there were significant positive correlation between hs-CRP and BMI in OSAHS patients (r=0.523,P＜0.01).significant negative correlation between hs-CRP and AHI (r=0.485,P＜0.05)and significant positive correlation between CRP and the average SaO2((r=-0.506,P＜0.05).
2.After UPPP eighty percents patients felt the symptom had changed.Stenosis of cavity of pharynx of all OSAHS patients had been improved.In general the serum level of crp of twenty OSAHS patients have reduced significantly after operation(r=4.818,P＜0.001).The serum level of crp of sixteen patients had reduced fourty pecents,the level of two patients had not reduced,but heigntened on the contrary.Two patients had not changed significantly.On the other hand the AHI had reduced,it had statistical significance(r=10.01,P＜0.001).The AHI eighteen patients had reduced more than 25 pecents,three patients had changed only 12 pecnets,9 pecnets. The effective power is 90 pecents.And the serum level of crp of the three patients were also not reduced.And the average SaO_2 at night and minimum SaO_2 were heightened.Tht the BMI had not changed.
Conclusion:1.The serum hs-CRP level of OSAHS patients and fat people were significantly higher than healthy people.C-reactive protein is the most valueable acute protein.All these can show that the highten of The serum hs-CRP level of fat people may have correlation with chronic inflammation in the fatness,especially centripetal fatness.Meanwhile,it also show that t the highten of the serum hs-CRP level of OSAHS people may have correlation with inflammation in uper respiration tube and apnea hypopnea.
2.After UPPP the serum hs-CRP level of OSAHS patients declined significantly,this can show that the UPPP can relieve the obstruction of part uper respiration tube to improve the estation of low oxyhgen at night and sleep quality,and then than inflammation reponse allleviate quickly.UPPP can recede the AHI, meanwhile it can effect inflammation by topical mechanism.We can see that the UPPP is one kind of efficiency operation method to treat the OSAHS,because it can decline obviously incidence and mortality of Cardiovascular Disease.
方法:选择经过我院多导睡眠图检查并根据中华医学会耳鼻咽喉分会2002年杭州会议标准确诊的20例适合行UPPP手术的OSAHS患者做为实验组,同时选取20例单纯肥胖的病人及20例健康人作为两个对照组,进行对照研究。实验血术前空腹取肘静脉血3 ml,采用免疫比浊法测定血清中的超敏C-反应蛋白,常规测量体重、身高,术后三个月再次复查PSG监测及血清C-反应蛋白的水平。
结果:1、OSAHS组和单纯肥胖组除体重指数(BMI Body Mass Index)值无明显差异(p＞0.5)外,hs-CRP及睡眠监测各项参数包括呼吸暂停低通气指数(AHI apnea hypopnea index)、夜间最低SaO_2及平均SaO_2均有明显差异(P＜0.05),而单纯肥胖组和正常组之间在BMI值和hs-CRP上的差异具有明显的统计学意义(P＜0.05),OSAHS组和正常组的hs-CRP、BMI、AHI、夜间最低SaO_2及平均SaO_2差异均有统计学意义(P＜0.05);OSAHS组的hs-CRP值与AHI之间存在明显正相关性(t=0.485,P＜0.05);hs-CRP值与平均SaO_2存在负相关性(t=-0.506,P＜0.05)。
2、UPPP手术术后三个月80%的患者自觉症状改善,检查见所有OSAHS患者的咽腔狭窄情况明显好转,未出现咽部明显的局部炎症反应。术后的hs-CRP值明显低于术后(r=4.818,P＜0.001),术后三个月患者的AHI值出现明显的下降(r=10.01,P＜0.001),夜间最低SaO_2及平均SaO_2均出现明显的提高。18例患者术后的AHI值较术前降低了60%以上,其中有16例患者的CRP值术后降低了40%以上,2例患者术后的的CRP值未见降低,反而有所升高。2例患者的AHI值仅降低12%和9%,其术后的hs-CRP值也未发生明显的变化。
结论:1、OSAHS患者及单纯肥胖者的血清hs-CRP含量都明显高于正常者,而C-反应蛋白(C-reactive protein,CRP)是目前最有价值的急性时相反应蛋白,可以说明肥胖患者的hs-CRP的水平增高可能与肥胖本身处于慢性炎症状态有关。同时也提示OSAHS组hs-CRP水平的提高可能与呼吸暂停及上呼吸道的炎症有关。
2、OSAHS患者行UPPP手术后血清中的hs-CRP水平含量明显下降,说明UPPP手术可以通过解除部分上呼吸道阻塞而改善上气道的夜间低氧状态和睡眠质量,炎症反应迅速减轻,UPPP除了降低AHI的同时可能可以通过局部的机制影响炎症,UPPP手术是一种治疗OSAHS患者有效的手术方法之一,可以大大降低OSAHS患者心血管疾病的发生率和死亡率。
Objective:To explore the changes of the serum high sensitive C-creative protein level in patientse who have been diagnosised as OSAHS and the effect of fatness on this change.Meanwhile we will explore the effects of uvulopalatopharyngoplasty(UPPP)on high sensitive C-creative protein(hs-CRP)in serum of patients with obstructive sleep apnea hypopnea syndrome(OSAHS).
Method:We chose twenty patients as the experimental group who have been diagnosised as OSAHS and must be operated by UPPP after monitored by PSG in my hospital.Meanwhile we aslo chose twenty fat people without any other disease and twenty healthy people as two control groups.We compared these three groups in all index.The concentration of serum high sensitive C-creative protein(hs-CRP)level were measured with ELISA in the experimental group(n=20)and two control groups. The vein blood must be extracted before breaskfast in the morning.Three months after operation,OSAHS patients were monitored by PSG and serum high sensitive C-creative protein(hs-CRP)level were measured again.
Result:1.BMI of The OSAHS group and that of the fatness group hsve no significant difference(P＞0.5).But other index have significant difference (P＜0.05).BMI and C-creative protein(hs-CRP)level of the fatness group and that of the healthy have significant difference(P＜0.05).The OSAHS group and the healthy have significant difference in all index(P＜0.05).Before treatment,there were significant positive correlation between hs-CRP and BMI in OSAHS patients (r=0.523,P＜0.01).significant negative correlation between hs-CRP and AHI (r=0.485,P＜0.05)and significant positive correlation between CRP and the average SaO2((r=-0.506,P＜0.05).
2.After UPPP eighty percents patients felt the symptom had changed.Stenosis of cavity of pharynx of all OSAHS patients had been improved.In general the serum level of crp of twenty OSAHS patients have reduced significantly after operation(r=4.818,P＜0.001).The serum level of crp of sixteen patients had reduced fourty pecents,the level of two patients had not reduced,but heigntened on the contrary.Two patients had not changed significantly.On the other hand the AHI had reduced,it had statistical significance(r=10.01,P＜0.001).The AHI eighteen patients had reduced more than 25 pecents,three patients had changed only 12 pecnets,9 pecnets. The effective power is 90 pecents.And the serum level of crp of the three patients were also not reduced.And the average SaO_2 at night and minimum SaO_2 were heightened.Tht the BMI had not changed.
Conclusion:1.The serum hs-CRP level of OSAHS patients and fat people were significantly higher than healthy people.C-reactive protein is the most valueable acute protein.All these can show that the highten of The serum hs-CRP level of fat people may have correlation with chronic inflammation in the fatness,especially centripetal fatness.Meanwhile,it also show that t the highten of the serum hs-CRP level of OSAHS people may have correlation with inflammation in uper respiration tube and apnea hypopnea.
2.After UPPP the serum hs-CRP level of OSAHS patients declined significantly,this can show that the UPPP can relieve the obstruction of part uper respiration tube to improve the estation of low oxyhgen at night and sleep quality,and then than inflammation reponse allleviate quickly.UPPP can recede the AHI, meanwhile it can effect inflammation by topical mechanism.We can see that the UPPP is one kind of efficiency operation method to treat the OSAHS,because it can decline obviously incidence and mortality of Cardiovascular Disease.
引文
[1]Somers VK,Dyken ME,Clary MP,et al.Sympathetic neural mechanisms in obstructive sleep apnea[J].Clin Invest 1995;96:1897-904.
[2]Auer J,Bcrent R,Lassnig E,et al.C-reactive Protein and Coronary arterydisease[J].HeartJ,2002,43(6):607-619.
[3]李旭.超敏C-反应蛋白预测心血管疾病研究进展[J].中国医学检验杂志,2006,7(4):305-306.
[4]国际生命学学会中国肥胖问题工作组联合数据汇总分析协作组.中国成人体质质数分类的推荐意见[J].中国预防医学杂志,2001,35(5):349.
[5]傅华.社区预防与保健[M].北京:人民卫生出版社,2001,28-284.
[6]O'donneN CP,Se haub CD,Haines AS.Leptin prevents respiratory depression in obesity[J].Am J Respir Crit Care Med,1999,159(5 Pt 1):1477-1484.
[7]Bixler EO,Vgontzas AN,Lin HM,et al.Prevalence of sleep-disordered breathing in women:effects of gender[J].Am J Respir Crit Care Med,2001,163:608-613.
[8]Zohar Y,Sabo R,Strauss M,et al.Oropharyngeal fatty infiltration in obstructive sleep apnea patients:a histologic study[J].Ann Otol Rhinol Laryngol,1998,107:170-174.
[9]Shehon KE,Woodson H,Gay S,et al.Pharyngeal fat in obstructive sleep apnea[J].Am Rev Respir Dis,1993,148:462-466.
[10]Stauffer JL,Buick MK,Bixler EO,et al.Morphology of the uvula in obstructive sleep apnea[J].Am Rev Respir Dis,1989,140(3):724-728.
[11]杨胜利,何秉贤.C一反应蛋白与冠心病.中华心血管病杂志,2001,29:187-188.
[12]卓绮玲,林增文.超敏CRP一心血管疾病的独立危险因子[J].国外医学临床生物学与检验学分册,2004,25:72-74.
[13]Visser M,Bouter L M,,McQuillan G M.Elevated C-reactive protein levels in overweight and obese adults[J].JAMA,1999,282:2131-5.
[14]Yudkin J S,Stehouwer C D,Emeis J,et al.C-reactive protein in healthy subjects:associations with obesity,insulin resistance,and endothelial dysfunction:: a potential role for cytokines originating from adipose tissue? [J]. Arterioseler Thromb Vase Biol, 1999, 19(4): 972-978.
[15] Peden BK, Bruunsgard H. Possible beneficial role of exercise inmodulating low-grade inflammation in the elderly [J]. Scand JMed Sci Spots, 2003, 13(1) 56-62.
[16] Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Slep apnea anddaytime sleepiness and fatigue: relation to visceral obesity, insult in resistance, and hypercytokinemia[J]. J Clin Endocrinol Metab, 2000, 85: 1151-1158.
[17] Weyer C, Yudkin JS, Stehouwer CD, et al. Humoral markers of inflammafion an d endothelial dysfunction in relation to adiposity an d in vivo insulin action in Pima Indians[J]. Atherosclerosis, 2002, 161(1): 233-242.
[18] Ziccardi P, Nappo F, Giugliano G, et al. Reduction of inflammatory cytokine concentrations and improvement of endothelial functions inobese women after weight loss over one year [J]. Circulation, 2002, 105 (7): 804-809.
[19]Vozarova B, Weyer C, Hanson K, et al. Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion [J]. Obeses, 2001, 9(7): 414-417.
[20] Visser M, Bouter LM, McQuilan GM. et al Elevated C -reactive protein level in overweight and obese adults[J]. JAMA, 1999, 282(22): 2131-2135.
[21]Diamantopoulos EJ, Andreadis EA, Tsourous GI, et al. Metabolic syndrome and prediabetes identify overlapping but not identical populations[J]. Exp Clin Endocrinol Diabetes, 2006, 114(7): 377-383.
[22]Rodila E, Costa JA, Mares S, et al. Impact of metabolic syndrome on CRP levels [J]. Rev Clin Esp, 2006, 206 (8) : 363-368.
[23] Heilbronn LK, Noakes M, Clifton PM, et al. Energy restriction and weight loss on very-low-fat diets reduce C-reactive protein concentrations in obese heath women[J]. Atheroscler Thromb Vasc Biol, 2001, 21(6): 968-970.
[24] Thorand B, Lowel H, Schneider A, et al. C-reactive protein as a predictor for incident diabetes mellitus among middle-aged men: results from the MONICA Augsburg cohort study, 1984-1998[J]. Arch Intern M, 2003, 163(1): 93-99.
[25] Chambers JC, Eda S, et al. C-reactive protein, insulinresistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites[J].Circulation,2001,104(2):145-150.
[26]Kanda T,Takahashi T.Interleukin-6 and cardiovascular diseases[J].Jpn Heart,2004,45:183-93.
[27]Hartmann G,Tschop M,Fischer R,et al.High altitude in crease circulating Inter ukin-6,interleukin-1 receptor antagonist and C-reactive protein[J],Cytokine,2000,12:246-252.
[28]Peled N,Greenberg A,Pillar G,et al.Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome[J].Am J Hypertens,1998,11:1284-1289.
[29]S.M.Shamsuzzaman,Mikolaj Winnicki,Poola Lamfranchi.Elevated C-Reactive Protien in Pa七ients With Obstructive Sleep Apnea[J].Circulation,2002,105:2462-2464.
[30]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[31]Kiely JL,Nolan P,McNichola8 WT.Intranasul corticosteroid therapy for obstructive slep apnoea in patients witlI co-existing rhimtis[J].ThOrax.2004.59:50-55.
[32]Elsolh AA,Med or MJ,Sikka P et al,Adhesion moleculea in patients with coronary artery disease an d moderate-to-desevere obstructive sleep apnea[J].Chest,2002,121:1541-1547.
[33]Flemons W W.Clinical practice,Obstructive sleep apnea[J].N Ensl J Med,2002,347:498-504.
[34]Kingman P.Stroh.阻塞性睡眠呼吸暂停低通气综合征诊断和治疗的新认识[J].中华医学杂志,2007,87(31):2163-2166.
[35]Giles TL,Lasserson TJ,Smith BJ,et al.Continuous positive air ways pressure for obstructive sleep apnoea in adults[J].Cochrane Database Syst Rev,2006(1):CD001106.
[36]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J]. Circulation, 2003, 107: 1129-1134.
[37] Kazoo Chin, Takaya Nakamura, Kouichi Shimizu. Effects of nasal continuous positive airway pressure on soluble cell adhesionmolecules in patients with obstructive sleep apnea syndrome [J]. Am J Med, 2000: 109(77): 562-567.
[38] Eijiro Ohga, Tetsuji Tomita, Hiroo Wada, Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1[J]. J Appl Physiol, 2003, 94: 179-184.
[39] Bomwiecki BD, Sasin JF. Surgical Treatment of Sleep Apnea[J]. Arch Otolaryngol, 983, 109: 506-512.
[40] Suto Y, Maysuo T, Hori I, et al. Evaluation of the Pharyngeal Airway in Patients with Sleep Apnea : Value of Ultrafast MR Imagine [J]. AIR, 1993, 160: 311.
[41] Salerno F G, Carpagnano E, Guido P, et al. Airway inflammation in patients affected by obstructive sleep apnea syndrome [J]. RespirMed, 2004, 98:25-8.
[42] Sher AE, Sehechtman KB, Piccirillo JF. The Eficacy ofSurgical Modification of the Upper Airway in Adults with Obstructive Sleep Apnea Syndrome[J]. Sleep, 1996, 19: 156-177.
[43] Usui K, Bradley T D, Spaak J, et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure[J]. Am Coll Cardiol, 2005, 45: 2008-11.
[44] Somers V K, Dyken M E, Clary M P, et al. Sympathetic neural mechanisms in obstructive sleep apnea[J], Clin Invest, 1995, 96: 1897-904.
[45] Danesh J, Collins R, Peto R. Chronic infections and coronary heart disease: Is there a link[J]. Lancet, 1997, 350: 430-436.
[46] Toss H, 1. indahl B, Siegbahn A, el al. Prognostic influence of increased fibrinogen and Creactive protein levels in unstable coronary artery disease[J]. Circulation, 1997, 96: 4204-4210.
[47] Lagrand WK, NiessenJW, WolbinkOJ, el al. C-reactive protein coloealizes with complement in hunmn hearts during acute mvoeardial infarction[J]. Circulation, 1997, 95: 97-103.
[48] Ridker PM, Rifai N, Rose L, et al. Comparison of C-reactive proteinand low-density lipoprotein cholesterol levers in the prediction of first cardiovascular events[J].N Engl J Med,2002,347:1557-156.
[49]Edward T,James T.Coming of Age of C-Reactive Protien[J].Circulation,2003,107:370-371.
[50]陈学军,李建军.C反应蛋白与动脉粥样硬化[J].中国动脉硬化杂志,2002,10:355-357.
[51]Pasceriv,Chang J,Willerson JT,et al.Modulation of C-reactive protein mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs[J].Circulation,2001,103(2):531-534.
[52]Zwaka TP,Hombach V,Tovzewski J.C-reactive protein-mediated low density lipoprotein uptake by macrophages implication for atherosclerosis[J].Circulation,2001,103:1194-197.
[53]Ridker PM,Cushman,Stampfer MJ,et al.Plasma Concentration of C-reactive protein and risk of developing peripheral vascular disease[J].Circulation,1998,97:425-428.
[54]Aber J,Murin J,Kinova S,et al.The role of infection and inflammation in the pathogenesis of atherosclerosis[J].Vnitr Lek,2002,48:657-666.
[55]戴玉华,黄席珍,邹丁.睡眠呼吸障碍与心血管疾病.中华结核和呼吸杂志,1998,21:460-462.
[56]Pawar R,jr jT W,Smith M,et al.Blood pressure regulation and sleep apnea[J].A Receive CVRS-R,1995,10(4):125-126.
[57]韩德民.促进阻塞性睡眠呼吸暂停低通气综合征临床研究的发展[J].中华耳鼻咽喉科杂志,2002,37(6):401-403.
[58]佘万东.阻塞性睡眠呼吸暂停综合症悬雍垂腭咽成形术的临床观察[J].中华耳鼻咽喉科杂志,2001,36(3):227 228.
[59]刘永义,何海林,姚大康等.阻塞性睡眠呼吸暂停低通气综合征对心血管功能影响的动态观察[J].中国微循环,2003,7(5):316-317.
[60]Vgontzas AN,Papnicolaou DA,Bixler EO,et al.Elevation of plasma cytokine in disorder of excessive daytime sleepiness:role of sleep disturbance and obesity[J].J Clin Endocrinol Metab,1997,82:1313-1316.
[61]Kokturk O,Ciftci TU,Mollarecep E.et al.Elevated C-reactive protein levels and increased cardiovascular risk in patients with Obstructive sleep apnea syndrome[J]. Int Heart J, 2005, 46(5): 801-809.
[62] Chin K, Ohi M. et al. Effects of nCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome [J]. Am J Respir Crit Care Med. 1996, 153: 1972-1976.
[1]Gabay C,Kushner I.Acute-phase protein and other systemic responses to inflammation[J].N Engl J Med,1999,340:448-454.
[2]Du Clos TW.Function of C-reactive protein[J].Ann Med,2000,32:174-278.
[3]冯仁丰.急性相和C反应蛋白.上海医学检验杂志,1999,14:258-260.
[4]孟斌,陈风.C-反应蛋白对心血管病的预测作用[J].中西医结合心脑血管病杂志,2006,4(9):797-798.
[5]Thompson D,Pepys MB,Wood SP.The physiologica struchll-of huin,an C-reactive protein and its complex with phosphochline[J].Reprinted from Structure,1999,7:169-177.
[6]冯仁丰.急性相和c反应蛋白[J].上海医学检验杂志,1999,14(5):258-260.
[7]杨胜利,何秉贤.C-反应蛋白与冠心病[J].中华心血管病杂志,2001,29:187-188.
[8]SungHJ,Kim JH,ParkR,et al.Evaluation Of enka-Seike-lturbidimetrie highsensitivity C-reactive protein assay[J].Clin Chem Lab Ned,2002,40:840-845.
[9]Sanehez A,Mirabel JL,BalTenechea E,et al.Evaluation Of all improved irrantmoturbidimetrie assay for 8elllm C-reaelive protein on a COBAS IN'IEGRA 400 Analyzer[J].Clin Lab,2002,48:313-317.
[10]Meier-Ewert HK,Ridker,Rifai N,et al.Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects[J].ClinChem,2001,47:426-430.
[11]Danesh J,Collins R,Peto R.Chronic infections and coronary heart disease:Is there alink[J].Lancet,1997,350:430-436.
[12]Toss H,Tindahl B,Siegbahn A,el al.Prognostic influence of increased fibrinogen and Creactive protein levels in unstable coronary artery disease[J].Circulation,I997,96:4204-4210.
[13]Lagrand WK,Niessen JW,Wolbink OJ,et al.C-reactive protein coloealizes with complement in hunmn hearts during acute mvoeardial infarction[J].Circulation,1997,95:97-103.
[14]Haverkate F,Thompmn SG,Pyke SD,el al Prcxhtction of C-reactive protein and risk of coronary ecents in stable and unstable angina:European concerted actkm on thromF,sis and dibliities attgina pectoris study group[J].Lancet,1997,349:462-466.
[15]Ridker PM,Rifai N,Pfeffer MA,et al.Inflammation,pravatatin and the risk of coronary events after nl} c,cardial infarction in patient with average cholesterol levels:Cholesterol and recurrent events(CARE)investigators[J].Circulation,1998,98:839-844.
[16]Liuzzo G,Biasucci LM,Gallimore JR,et al.The prognostic:valuc of C-reactive protein and serum amyloid a peotein in severe unstable angina[J].N Engl J Med,1994,331:417-424.
[17]Winter RJ,Bholasingh R,Lijmer JG,et al.Independent prognostic value of C-reactive protein and troponin I in patients with un stable angina or non-Q-wave myocardial infarction[J].Cardiovasc Res,1999,42:240-245.
[18]Dinapoli M,Digiantilippa G,Sollecito A,et al.C-reactive protein and outcome after first ever isehemic stroke[J].Stroke,2000,31(1):238-239.
[19]Dinnapoli M,Papa F,Ikmola V.Prognostic influence of increased C-reactive protein and fibrinogen levels in isehemic stroke[J].Stroke,2001.32(1):133-138.
[20]Edward T,James T.Coming of Age of C-Reactive Protien[J].Circulation,2003,107:370-371.
[21]陈学军,李建军.C反应蛋白与动脉粥样硬化[J].中国动脉硬化杂志.2002.10:355-357.
[22]Pasceriv,Chang J,Willerson JT,et al.Modulation of C-reactive protein mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs[J].Circulation,2001,103(2):531-534.
[23]Libby P et al.Inflammation and thrombosis.,the clot thiekel 18[J].Circulation,2001,103:1718.
[24]Paseefi V,et al.Direct Proinflammatory effect of CRP in human endothelialcells[J].Circulation,2000,102:2165.
[25]Paseefi V et al.Moduhtion of CRP-mediated monocyte chemoattraetant Protein-1 induction in human endothelial cells by anti athemclero-sis drugs[J].Circulation,2001,103:2531.
[26]Zwaka TP,Hombach V,Tovzewski J.C-reactive protein-mediated low density lipoprotein uptake by macrophages implication for atherosclerosis[J].Circulation,2001,103(1):194-197.
[27]S.M.Shamsuzzaman,Mikolaj Winnicki,Poola Lamfranchi.Elevated C-Reactive Protien in Pa七ients With Obstructive Sleep Apnea[J].Circulation,2002,105:2462-2464.
[28]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[29]Hartmann G,Tschop M,Fischer R,et al.High altitude in crease circulating interleukin-6,interleukin-1 receptor antagonist and C-reactive protein[J].Cytokine,2000,12:246-252.
[30]Kanda T,Takahashi T.Interleukin-6 and cardiovascular diseases[J].Jpn Heart,2004,45:183-193.
[31]叶民等.体重指数与阻塞性睡眠呼吸暂停低通气综合征的关系[J].浙江临床医学,2005,7(10):1073.
[32]王朝迅,裴海成,金红梅等.超重和肥胖者血清TNF-Ot、IL-6及CRP与肥胖的关系[J].Tianjin Med J,2007,35(5):333-334.
[33]Diamantopoulos EJ,Andreadis EA,Tsourous GI,et al.Metabolic syndrome and prediabetes identify overlapping but not identical populations[J].Exp Clin Endocrinol Diabetes,2006,114(7):377-383.
[34]Rodila E,Costa JA,Mares S,et al.Impact of metabolic syndrome on CRP levels[J].Rev Clin Esp,2006,206(8):363-368.
[35]Vgontzas AN,Papanicolaou DA,Bixler EO,et al.Slep apnea anddaytime sleepiness and fatigue:re,lation to visceral obesity,insult in resistance,an d hypercytokinemia[J].J Clin Endocrinol Metab,2000,85:1151-1158.
[36]Visser M,Bouter L M,McQuillan G M.Elevated C-reactive protein levels in overweight and obese adults[J].JAMA,1999,282:2131-5.
[37]Yudkin J S,Stehouwer C D,Emeis J,et al.C-reactive protein in healthy subjects:associations with obesity,insulin resistance,and endothelial dysfunction:a potential role for cytokines originating from adipose tissue?[J].Arterioseler Thromb Vase Biol,1999,19(4):972-978.
[38]Kiely JL,Nolan P,McNichola8 WT.Intranasul corticosteroid therapy for obstructive sleep apnoea in patients witlI co-existing rhimtis[J].ThOrax,2004,59:50-55.
[39]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[40]Kazoo Chin,Takaya Nakamura,Kouichi Shimizu.Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome[J].Am J Med,2000,109(77):562-567.
[41]Eijiro Ohga,Tetsuji Tomita,Hiroo Wada.Effects of obstructive sleep apnea on circulating ICAM-1,IL-8,and MCP-1[J].J Appl Physiol,2004,120(78):56-58.
[42]Giles TL,Lasserson TJ,Smith BJ,et al.Continuous positive air ways pressure for obstructive sleep apnoea in adults[J].Cochrane Database Syst Rev,2006,1:CD001106.
[43]Ridker PM,Cushman,Stampfer MJ,et al.Plasma Concentration of C-reactive protein and risk of developing peripheral vascular disease[J].Circulation,1998,97:425-428.
[44]J,Murin J,Kinova S,et al.The role of infection and inflammation in the pathogenesis of atherosclerosis[J].Vnitr Lek,2002,48:657-666.
[45]戴玉华,黄席珍,邹丁.睡眠呼吸障碍与心血管疾病[J].中华结核和呼吸杂志,1998,21:460-462.
[46]韩德民.促进阻塞性睡眠呼吸暂停低通气综合征临床研究的发展[J].中华耳鼻咽喉科杂志.2002,37(6):401-403
[47]佘万东.阻塞性睡眠呼吸暂停综合症悬雍垂腭咽成形术的临床观察[J]中华耳鼻咽喉科杂,2001,36(3):227-228.
[48]刘永义,何海林,姚大康等.阻塞性睡眠呼吸暂停低通气综合征对心血管功能影响的动态观察[J].中国微循环,2003,7(5):316-317.
[49]Vgontzas AN,Papnicolaou DA,Bixler EO,et al.Elevation of plasma cytokine in disorder of excessive daytime sleepiness:role of sleep disturbance and obesity[J]. J Clin Endocrinol Metab, 1997, 82: 1313-1316.
[50] Kokturk O, Ciftci TU, Mollarecep E. et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with Obstructive sleep apnea syndrome[J].Int Heart J,2005,46(5):801-809.
[51] Noguchi T, Chin K, Ohi M, et al.Heat shock protein 72 level decrease during sleep in patients with obstructive sleep apnea syndrome[J].Am J Respir Crit Care Med, 1997;155:1316.
[52] Strohl KP, Cherniaek NS,Gothe B.Physiologic basis of therapyfor sleep apnea[J].Am Rev Respir Dis, 2006, 134:791-802.
[53] Flemons W.Clinical practice Obs tructive sleep apnea[J]. N Ensl J Med, 2002,347:498-504.
[2]Auer J,Bcrent R,Lassnig E,et al.C-reactive Protein and Coronary arterydisease[J].HeartJ,2002,43(6):607-619.
[3]李旭.超敏C-反应蛋白预测心血管疾病研究进展[J].中国医学检验杂志,2006,7(4):305-306.
[4]国际生命学学会中国肥胖问题工作组联合数据汇总分析协作组.中国成人体质质数分类的推荐意见[J].中国预防医学杂志,2001,35(5):349.
[5]傅华.社区预防与保健[M].北京:人民卫生出版社,2001,28-284.
[6]O'donneN CP,Se haub CD,Haines AS.Leptin prevents respiratory depression in obesity[J].Am J Respir Crit Care Med,1999,159(5 Pt 1):1477-1484.
[7]Bixler EO,Vgontzas AN,Lin HM,et al.Prevalence of sleep-disordered breathing in women:effects of gender[J].Am J Respir Crit Care Med,2001,163:608-613.
[8]Zohar Y,Sabo R,Strauss M,et al.Oropharyngeal fatty infiltration in obstructive sleep apnea patients:a histologic study[J].Ann Otol Rhinol Laryngol,1998,107:170-174.
[9]Shehon KE,Woodson H,Gay S,et al.Pharyngeal fat in obstructive sleep apnea[J].Am Rev Respir Dis,1993,148:462-466.
[10]Stauffer JL,Buick MK,Bixler EO,et al.Morphology of the uvula in obstructive sleep apnea[J].Am Rev Respir Dis,1989,140(3):724-728.
[11]杨胜利,何秉贤.C一反应蛋白与冠心病.中华心血管病杂志,2001,29:187-188.
[12]卓绮玲,林增文.超敏CRP一心血管疾病的独立危险因子[J].国外医学临床生物学与检验学分册,2004,25:72-74.
[13]Visser M,Bouter L M,,McQuillan G M.Elevated C-reactive protein levels in overweight and obese adults[J].JAMA,1999,282:2131-5.
[14]Yudkin J S,Stehouwer C D,Emeis J,et al.C-reactive protein in healthy subjects:associations with obesity,insulin resistance,and endothelial dysfunction:: a potential role for cytokines originating from adipose tissue? [J]. Arterioseler Thromb Vase Biol, 1999, 19(4): 972-978.
[15] Peden BK, Bruunsgard H. Possible beneficial role of exercise inmodulating low-grade inflammation in the elderly [J]. Scand JMed Sci Spots, 2003, 13(1) 56-62.
[16] Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Slep apnea anddaytime sleepiness and fatigue: relation to visceral obesity, insult in resistance, and hypercytokinemia[J]. J Clin Endocrinol Metab, 2000, 85: 1151-1158.
[17] Weyer C, Yudkin JS, Stehouwer CD, et al. Humoral markers of inflammafion an d endothelial dysfunction in relation to adiposity an d in vivo insulin action in Pima Indians[J]. Atherosclerosis, 2002, 161(1): 233-242.
[18] Ziccardi P, Nappo F, Giugliano G, et al. Reduction of inflammatory cytokine concentrations and improvement of endothelial functions inobese women after weight loss over one year [J]. Circulation, 2002, 105 (7): 804-809.
[19]Vozarova B, Weyer C, Hanson K, et al. Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion [J]. Obeses, 2001, 9(7): 414-417.
[20] Visser M, Bouter LM, McQuilan GM. et al Elevated C -reactive protein level in overweight and obese adults[J]. JAMA, 1999, 282(22): 2131-2135.
[21]Diamantopoulos EJ, Andreadis EA, Tsourous GI, et al. Metabolic syndrome and prediabetes identify overlapping but not identical populations[J]. Exp Clin Endocrinol Diabetes, 2006, 114(7): 377-383.
[22]Rodila E, Costa JA, Mares S, et al. Impact of metabolic syndrome on CRP levels [J]. Rev Clin Esp, 2006, 206 (8) : 363-368.
[23] Heilbronn LK, Noakes M, Clifton PM, et al. Energy restriction and weight loss on very-low-fat diets reduce C-reactive protein concentrations in obese heath women[J]. Atheroscler Thromb Vasc Biol, 2001, 21(6): 968-970.
[24] Thorand B, Lowel H, Schneider A, et al. C-reactive protein as a predictor for incident diabetes mellitus among middle-aged men: results from the MONICA Augsburg cohort study, 1984-1998[J]. Arch Intern M, 2003, 163(1): 93-99.
[25] Chambers JC, Eda S, et al. C-reactive protein, insulinresistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites[J].Circulation,2001,104(2):145-150.
[26]Kanda T,Takahashi T.Interleukin-6 and cardiovascular diseases[J].Jpn Heart,2004,45:183-93.
[27]Hartmann G,Tschop M,Fischer R,et al.High altitude in crease circulating Inter ukin-6,interleukin-1 receptor antagonist and C-reactive protein[J],Cytokine,2000,12:246-252.
[28]Peled N,Greenberg A,Pillar G,et al.Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome[J].Am J Hypertens,1998,11:1284-1289.
[29]S.M.Shamsuzzaman,Mikolaj Winnicki,Poola Lamfranchi.Elevated C-Reactive Protien in Pa七ients With Obstructive Sleep Apnea[J].Circulation,2002,105:2462-2464.
[30]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[31]Kiely JL,Nolan P,McNichola8 WT.Intranasul corticosteroid therapy for obstructive slep apnoea in patients witlI co-existing rhimtis[J].ThOrax.2004.59:50-55.
[32]Elsolh AA,Med or MJ,Sikka P et al,Adhesion moleculea in patients with coronary artery disease an d moderate-to-desevere obstructive sleep apnea[J].Chest,2002,121:1541-1547.
[33]Flemons W W.Clinical practice,Obstructive sleep apnea[J].N Ensl J Med,2002,347:498-504.
[34]Kingman P.Stroh.阻塞性睡眠呼吸暂停低通气综合征诊断和治疗的新认识[J].中华医学杂志,2007,87(31):2163-2166.
[35]Giles TL,Lasserson TJ,Smith BJ,et al.Continuous positive air ways pressure for obstructive sleep apnoea in adults[J].Cochrane Database Syst Rev,2006(1):CD001106.
[36]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J]. Circulation, 2003, 107: 1129-1134.
[37] Kazoo Chin, Takaya Nakamura, Kouichi Shimizu. Effects of nasal continuous positive airway pressure on soluble cell adhesionmolecules in patients with obstructive sleep apnea syndrome [J]. Am J Med, 2000: 109(77): 562-567.
[38] Eijiro Ohga, Tetsuji Tomita, Hiroo Wada, Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1[J]. J Appl Physiol, 2003, 94: 179-184.
[39] Bomwiecki BD, Sasin JF. Surgical Treatment of Sleep Apnea[J]. Arch Otolaryngol, 983, 109: 506-512.
[40] Suto Y, Maysuo T, Hori I, et al. Evaluation of the Pharyngeal Airway in Patients with Sleep Apnea : Value of Ultrafast MR Imagine [J]. AIR, 1993, 160: 311.
[41] Salerno F G, Carpagnano E, Guido P, et al. Airway inflammation in patients affected by obstructive sleep apnea syndrome [J]. RespirMed, 2004, 98:25-8.
[42] Sher AE, Sehechtman KB, Piccirillo JF. The Eficacy ofSurgical Modification of the Upper Airway in Adults with Obstructive Sleep Apnea Syndrome[J]. Sleep, 1996, 19: 156-177.
[43] Usui K, Bradley T D, Spaak J, et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure[J]. Am Coll Cardiol, 2005, 45: 2008-11.
[44] Somers V K, Dyken M E, Clary M P, et al. Sympathetic neural mechanisms in obstructive sleep apnea[J], Clin Invest, 1995, 96: 1897-904.
[45] Danesh J, Collins R, Peto R. Chronic infections and coronary heart disease: Is there a link[J]. Lancet, 1997, 350: 430-436.
[46] Toss H, 1. indahl B, Siegbahn A, el al. Prognostic influence of increased fibrinogen and Creactive protein levels in unstable coronary artery disease[J]. Circulation, 1997, 96: 4204-4210.
[47] Lagrand WK, NiessenJW, WolbinkOJ, el al. C-reactive protein coloealizes with complement in hunmn hearts during acute mvoeardial infarction[J]. Circulation, 1997, 95: 97-103.
[48] Ridker PM, Rifai N, Rose L, et al. Comparison of C-reactive proteinand low-density lipoprotein cholesterol levers in the prediction of first cardiovascular events[J].N Engl J Med,2002,347:1557-156.
[49]Edward T,James T.Coming of Age of C-Reactive Protien[J].Circulation,2003,107:370-371.
[50]陈学军,李建军.C反应蛋白与动脉粥样硬化[J].中国动脉硬化杂志,2002,10:355-357.
[51]Pasceriv,Chang J,Willerson JT,et al.Modulation of C-reactive protein mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs[J].Circulation,2001,103(2):531-534.
[52]Zwaka TP,Hombach V,Tovzewski J.C-reactive protein-mediated low density lipoprotein uptake by macrophages implication for atherosclerosis[J].Circulation,2001,103:1194-197.
[53]Ridker PM,Cushman,Stampfer MJ,et al.Plasma Concentration of C-reactive protein and risk of developing peripheral vascular disease[J].Circulation,1998,97:425-428.
[54]Aber J,Murin J,Kinova S,et al.The role of infection and inflammation in the pathogenesis of atherosclerosis[J].Vnitr Lek,2002,48:657-666.
[55]戴玉华,黄席珍,邹丁.睡眠呼吸障碍与心血管疾病.中华结核和呼吸杂志,1998,21:460-462.
[56]Pawar R,jr jT W,Smith M,et al.Blood pressure regulation and sleep apnea[J].A Receive CVRS-R,1995,10(4):125-126.
[57]韩德民.促进阻塞性睡眠呼吸暂停低通气综合征临床研究的发展[J].中华耳鼻咽喉科杂志,2002,37(6):401-403.
[58]佘万东.阻塞性睡眠呼吸暂停综合症悬雍垂腭咽成形术的临床观察[J].中华耳鼻咽喉科杂志,2001,36(3):227 228.
[59]刘永义,何海林,姚大康等.阻塞性睡眠呼吸暂停低通气综合征对心血管功能影响的动态观察[J].中国微循环,2003,7(5):316-317.
[60]Vgontzas AN,Papnicolaou DA,Bixler EO,et al.Elevation of plasma cytokine in disorder of excessive daytime sleepiness:role of sleep disturbance and obesity[J].J Clin Endocrinol Metab,1997,82:1313-1316.
[61]Kokturk O,Ciftci TU,Mollarecep E.et al.Elevated C-reactive protein levels and increased cardiovascular risk in patients with Obstructive sleep apnea syndrome[J]. Int Heart J, 2005, 46(5): 801-809.
[62] Chin K, Ohi M. et al. Effects of nCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome [J]. Am J Respir Crit Care Med. 1996, 153: 1972-1976.
[1]Gabay C,Kushner I.Acute-phase protein and other systemic responses to inflammation[J].N Engl J Med,1999,340:448-454.
[2]Du Clos TW.Function of C-reactive protein[J].Ann Med,2000,32:174-278.
[3]冯仁丰.急性相和C反应蛋白.上海医学检验杂志,1999,14:258-260.
[4]孟斌,陈风.C-反应蛋白对心血管病的预测作用[J].中西医结合心脑血管病杂志,2006,4(9):797-798.
[5]Thompson D,Pepys MB,Wood SP.The physiologica struchll-of huin,an C-reactive protein and its complex with phosphochline[J].Reprinted from Structure,1999,7:169-177.
[6]冯仁丰.急性相和c反应蛋白[J].上海医学检验杂志,1999,14(5):258-260.
[7]杨胜利,何秉贤.C-反应蛋白与冠心病[J].中华心血管病杂志,2001,29:187-188.
[8]SungHJ,Kim JH,ParkR,et al.Evaluation Of enka-Seike-lturbidimetrie highsensitivity C-reactive protein assay[J].Clin Chem Lab Ned,2002,40:840-845.
[9]Sanehez A,Mirabel JL,BalTenechea E,et al.Evaluation Of all improved irrantmoturbidimetrie assay for 8elllm C-reaelive protein on a COBAS IN'IEGRA 400 Analyzer[J].Clin Lab,2002,48:313-317.
[10]Meier-Ewert HK,Ridker,Rifai N,et al.Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects[J].ClinChem,2001,47:426-430.
[11]Danesh J,Collins R,Peto R.Chronic infections and coronary heart disease:Is there alink[J].Lancet,1997,350:430-436.
[12]Toss H,Tindahl B,Siegbahn A,el al.Prognostic influence of increased fibrinogen and Creactive protein levels in unstable coronary artery disease[J].Circulation,I997,96:4204-4210.
[13]Lagrand WK,Niessen JW,Wolbink OJ,et al.C-reactive protein coloealizes with complement in hunmn hearts during acute mvoeardial infarction[J].Circulation,1997,95:97-103.
[14]Haverkate F,Thompmn SG,Pyke SD,el al Prcxhtction of C-reactive protein and risk of coronary ecents in stable and unstable angina:European concerted actkm on thromF,sis and dibliities attgina pectoris study group[J].Lancet,1997,349:462-466.
[15]Ridker PM,Rifai N,Pfeffer MA,et al.Inflammation,pravatatin and the risk of coronary events after nl} c,cardial infarction in patient with average cholesterol levels:Cholesterol and recurrent events(CARE)investigators[J].Circulation,1998,98:839-844.
[16]Liuzzo G,Biasucci LM,Gallimore JR,et al.The prognostic:valuc of C-reactive protein and serum amyloid a peotein in severe unstable angina[J].N Engl J Med,1994,331:417-424.
[17]Winter RJ,Bholasingh R,Lijmer JG,et al.Independent prognostic value of C-reactive protein and troponin I in patients with un stable angina or non-Q-wave myocardial infarction[J].Cardiovasc Res,1999,42:240-245.
[18]Dinapoli M,Digiantilippa G,Sollecito A,et al.C-reactive protein and outcome after first ever isehemic stroke[J].Stroke,2000,31(1):238-239.
[19]Dinnapoli M,Papa F,Ikmola V.Prognostic influence of increased C-reactive protein and fibrinogen levels in isehemic stroke[J].Stroke,2001.32(1):133-138.
[20]Edward T,James T.Coming of Age of C-Reactive Protien[J].Circulation,2003,107:370-371.
[21]陈学军,李建军.C反应蛋白与动脉粥样硬化[J].中国动脉硬化杂志.2002.10:355-357.
[22]Pasceriv,Chang J,Willerson JT,et al.Modulation of C-reactive protein mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs[J].Circulation,2001,103(2):531-534.
[23]Libby P et al.Inflammation and thrombosis.,the clot thiekel 18[J].Circulation,2001,103:1718.
[24]Paseefi V,et al.Direct Proinflammatory effect of CRP in human endothelialcells[J].Circulation,2000,102:2165.
[25]Paseefi V et al.Moduhtion of CRP-mediated monocyte chemoattraetant Protein-1 induction in human endothelial cells by anti athemclero-sis drugs[J].Circulation,2001,103:2531.
[26]Zwaka TP,Hombach V,Tovzewski J.C-reactive protein-mediated low density lipoprotein uptake by macrophages implication for atherosclerosis[J].Circulation,2001,103(1):194-197.
[27]S.M.Shamsuzzaman,Mikolaj Winnicki,Poola Lamfranchi.Elevated C-Reactive Protien in Pa七ients With Obstructive Sleep Apnea[J].Circulation,2002,105:2462-2464.
[28]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[29]Hartmann G,Tschop M,Fischer R,et al.High altitude in crease circulating interleukin-6,interleukin-1 receptor antagonist and C-reactive protein[J].Cytokine,2000,12:246-252.
[30]Kanda T,Takahashi T.Interleukin-6 and cardiovascular diseases[J].Jpn Heart,2004,45:183-193.
[31]叶民等.体重指数与阻塞性睡眠呼吸暂停低通气综合征的关系[J].浙江临床医学,2005,7(10):1073.
[32]王朝迅,裴海成,金红梅等.超重和肥胖者血清TNF-Ot、IL-6及CRP与肥胖的关系[J].Tianjin Med J,2007,35(5):333-334.
[33]Diamantopoulos EJ,Andreadis EA,Tsourous GI,et al.Metabolic syndrome and prediabetes identify overlapping but not identical populations[J].Exp Clin Endocrinol Diabetes,2006,114(7):377-383.
[34]Rodila E,Costa JA,Mares S,et al.Impact of metabolic syndrome on CRP levels[J].Rev Clin Esp,2006,206(8):363-368.
[35]Vgontzas AN,Papanicolaou DA,Bixler EO,et al.Slep apnea anddaytime sleepiness and fatigue:re,lation to visceral obesity,insult in resistance,an d hypercytokinemia[J].J Clin Endocrinol Metab,2000,85:1151-1158.
[36]Visser M,Bouter L M,McQuillan G M.Elevated C-reactive protein levels in overweight and obese adults[J].JAMA,1999,282:2131-5.
[37]Yudkin J S,Stehouwer C D,Emeis J,et al.C-reactive protein in healthy subjects:associations with obesity,insulin resistance,and endothelial dysfunction:a potential role for cytokines originating from adipose tissue?[J].Arterioseler Thromb Vase Biol,1999,19(4):972-978.
[38]Kiely JL,Nolan P,McNichola8 WT.Intranasul corticosteroid therapy for obstructive sleep apnoea in patients witlI co-existing rhimtis[J].ThOrax,2004,59:50-55.
[39]Takuya Yokoe,Kenji Minoguchi,Hiroumi Matsuo,et al.Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J].Circulation,2003,107:1129-1134.
[40]Kazoo Chin,Takaya Nakamura,Kouichi Shimizu.Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome[J].Am J Med,2000,109(77):562-567.
[41]Eijiro Ohga,Tetsuji Tomita,Hiroo Wada.Effects of obstructive sleep apnea on circulating ICAM-1,IL-8,and MCP-1[J].J Appl Physiol,2004,120(78):56-58.
[42]Giles TL,Lasserson TJ,Smith BJ,et al.Continuous positive air ways pressure for obstructive sleep apnoea in adults[J].Cochrane Database Syst Rev,2006,1:CD001106.
[43]Ridker PM,Cushman,Stampfer MJ,et al.Plasma Concentration of C-reactive protein and risk of developing peripheral vascular disease[J].Circulation,1998,97:425-428.
[44]J,Murin J,Kinova S,et al.The role of infection and inflammation in the pathogenesis of atherosclerosis[J].Vnitr Lek,2002,48:657-666.
[45]戴玉华,黄席珍,邹丁.睡眠呼吸障碍与心血管疾病[J].中华结核和呼吸杂志,1998,21:460-462.
[46]韩德民.促进阻塞性睡眠呼吸暂停低通气综合征临床研究的发展[J].中华耳鼻咽喉科杂志.2002,37(6):401-403
[47]佘万东.阻塞性睡眠呼吸暂停综合症悬雍垂腭咽成形术的临床观察[J]中华耳鼻咽喉科杂,2001,36(3):227-228.
[48]刘永义,何海林,姚大康等.阻塞性睡眠呼吸暂停低通气综合征对心血管功能影响的动态观察[J].中国微循环,2003,7(5):316-317.
[49]Vgontzas AN,Papnicolaou DA,Bixler EO,et al.Elevation of plasma cytokine in disorder of excessive daytime sleepiness:role of sleep disturbance and obesity[J]. J Clin Endocrinol Metab, 1997, 82: 1313-1316.
[50] Kokturk O, Ciftci TU, Mollarecep E. et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with Obstructive sleep apnea syndrome[J].Int Heart J,2005,46(5):801-809.
[51] Noguchi T, Chin K, Ohi M, et al.Heat shock protein 72 level decrease during sleep in patients with obstructive sleep apnea syndrome[J].Am J Respir Crit Care Med, 1997;155:1316.
[52] Strohl KP, Cherniaek NS,Gothe B.Physiologic basis of therapyfor sleep apnea[J].Am Rev Respir Dis, 2006, 134:791-802.
[53] Flemons W.Clinical practice Obs tructive sleep apnea[J]. N Ensl J Med, 2002,347:498-504.