冠状动脉血管狭窄程度与睡眠呼吸暂停的相关性研究

Correlation between coronary artery stenosis and sleep apnea

目的阻塞性睡眠呼吸暂停(OSA)被认为是冠心病(CHD)的风险因素,本研究拟探讨OSA与冠状动脉血管狭窄程度之间的关系。方法入选疑似CHD患者420例,所有受试者行冠状动脉造影并计算Gensini评分判断冠状动脉血管狭窄程度、多导联睡眠呼吸监测测定呼吸暂停低通气指数(AHI),分析冠状动脉血管狭窄程度与OSA的相关性。结果Gensini评分≥80患者的年龄、AHI及高血压、糖尿病、OSA患病率高于Gensini评分<80患者组(P<0.01)。与无OSA患者和轻度OSA患者比较,中度、重度OSA患者Gensini评分均明显增高(P=0.007,0.037)。Logistic回归分析:总体人群中,年龄、男性、AHI、高血压、糖尿病是Gensini评分≥80的风险因素。在年龄≥55岁组,校正性别和年龄后,AHI升高增加Gensini评分≥80的风险(OR=1.03,95%CI:1.00~1.05,P<0.05)。在年龄<55岁患者中,合并糖尿病较无糖尿病患者Gensini评分≥80风险增加1.77倍(OR=2.77,95%CI:1.29~5.94,P<0.05)。结论冠状动脉血管狭窄程度是与AHI具有相关性,中度、重度OSA患者Gensini评分更高,年龄≥55岁的患者Gensini评分与AHI独立相关。

Objective Obstructive sleep apnea(OSA)has been considered as a risk factor for coronary heart disease(CHD).This study was designed to investigate the relationship between OSA and coronary artery stenosis.Methods A total of 420 patients with suspected CHD were selected.All subjects underwent coronary angiography,and Gensini score was calculated to determine the severity of coronary artery stenosis.Then polysomnography was used to determine apnea hypopnea index(AHI).Finally,the correlation between the severity of coronary artery stenosis and OSA was analyzed.Results Patients with Gensini score≥80 had higher age,AHI,and prevalence of hypertension,diabetes and OSA than patients with Gensini score<80(P<0.01).Gensini scores of patients with moderate and severe OSA were significantly higher than those of patients without OSA or with mild OSA(P=0.007,0.037).Logistic regression analysis found that age,male,AHI,hypertension and diabetes were risk factors for Gensini score≥80 in the overall population.In the age≥55 group,after adjusting for gender and age,AHI elevation increased the risk of Gensini score≥80(OR=1.03,95%CI:1.00-1.05,P<0.05).In patients<55 years of age,the risk of Gensini score≥80 was 1.77 times higher in patients with diabetes than those without diabetes(OR=2.77,95%CI:1.29-5.94,P<0.05).Conclusion The severity of coronary stenosis was correlated with AHI.Gensini score was higher in patients with moderate and severe OSA,and it was independently correlated with AHI in patients aged≥55 years.