| Objective : Obstructive sleep apnea hypopnea syndrome is associated with hypercoagulability. Thrombelastogram has a good predictive value for hypercoagulability. However, the relationship between TEG and OSAHS still remains unclear. The purpose of this study was to evaluate the relationship between TEG and the severity of OSAHS.Methods:We studied 88 patients with clinical suspicion of OSAHS between july 2014 to August 2015. Patients with a history of malignant neoplasm hematological system diseases, rheumatic disease, chronic obstructive pulmonary disease were excluded. Blood fast samples were taken from all patients to analyze levels of TEG, total cholesterol and triglycerides. Patients were divided into mild OSAHS group, moderate OSAHS group and severe OSAHS group according to AHI.Result:1.There was no statistically significant difference between control group and OSAHS group in height,high density lipoprotein, apolipoprotein. But there was statistically significant in AHI,AHTI,ODI,BMI,TEG and other indexes. 2. Patients were divided into mild OSAHS group, moderate OSAHS group and severe OSAHS group according to AHI:(1) The clot reaction time levels were significantly shorter in patients with severe OSAHS group than in controls and mild OSAHS group(4.5[4.3-4.9] vs. 6.3[5.9-6.7]vs.5.2[5.0-5.3] min),(P <0.05);Compared with moderate OSAHS group, there was no statistically significant difference(P=0.852);The clot reaction time levels were significantly shorter in patients with moderate OSAHS group than in controls and mild OSAHS group(P<0.001,0.013,respectively);(2)The clot kinetics were significantly longer in control group than mild, moderate, sever OSAHS group(2.1±0.3 vs. 1.7±0.4 vs. 1.6±0.4 vs. 1.6±0.3 min)(p<0.05),but there was no statistically significant difference among OSAHS patients.(3)The alpha angle were significantly smaller in control group than mild, moderate, sever OSAHSgroup(60.7±4.4 vs. 68.5±4.5 vs. 68.0±3.4 vs. 66.2±3.6)(P <0.05),but there was no statistically significant difference among OSAHS patients.(4)There was no statistically significant difference in control group and mild OSAHS group in maximum amplitude(P=0.062),but there was statistically significant difference among control group, moderate OSAHS and sever OSAHS( p=0.002, 0.007,respectively). 3.(1) A statistically significant negative association was observed between AHI,AHTI,TS90%,ODI and clot reaction time(r=-0.486,-0.468,-0.423,-0.519, respectively).(2) A statistically significant negative association was observed between AHI,AHTI,TS90% and clot kinetics(r=-0.486,-0.226,-0.423,respectively).(3) A statistically significant positive association was observed between age, hip circumference, triglyceride, very low density lipoprotein cholesterol and and alpha angle(r=0.237,0.252,0.256,0.270,respectively).(4) A statistically significant positive association was observed between weight, BMI, neck circumference, hip circumference and maximum amplitude(r=0.256,0.365,0.294,0.428,respectively). 4. Multiple liner regression analyses were performed to evaluate the independent predictors of clot reaction time, clot kinetics, alpha angle and maximum amplitude.(1)The analyses identified AHI,age,TG,red blood cell count as independent explanatory variables for clot reaction time(r square=0.437, adjusted r square=0.408).(2) The analyses identified hip circumference,APOB,red blood cell count, VLDL as independent explanatory variables for clot kinetics(r square=0.284, adjusted r square=0.248).(3) The analyses identified hip circumference,MSO2,AHI, age, TG as independent explanatory variables for alpha angle(r square=0.325 adjusted r square=0.282);(4) The analyses identified hip circumference,VLDL,PLT,AHTI,MSO2, TG as independent explanatory variables for maximum amplitude( r square=0.476 adjusted r square=0.435).Conclusion :TEG was associated with AHI, AHTI, MSO2 and other indexes in OSAHS patients Further studies are needed to explore its predictive value of hypercoagulability. |
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