发生在快速动眼期睡眠的阻塞性睡眠呼吸暂停对急性心肌梗死患者的预后影响

Effect of Obstructive Sleep Apnea during Rapid Eye Movement Period on Prognosis of Patients with Acute Myocardial Infarction

目的对急性心肌梗死(acute myocardial infarction,AMI)合并发生在快速动眼期睡眠的阻塞性睡眠呼吸暂停(obstructive sleep apnea during rapid eye movement period,REM-OSA)患者的一般资料进行分析,评价相关性。方法选取2019年5月-2020年1月于安徽医科大学附属省立医院住院的AMI患者。采用WatchPAT完成睡眠监测。根据快速动眼期睡眠呼吸低通气指数(apnea hypopnea index during rapid eye movement period,REM-AHI)将患者分为两组:中重度REM-OSA(REM-AHI>15)组,无或轻度REM-OSA(REM-AHI≤15)组,即对照组。收集患者的一般资料及睡眠资料,并进行随访。结果中重度REM-OSA组MACE发生率高于对照组,且两者无事件生存时间差异存在统计学意义(P<0.05)。单因素Cox回归分析显示BMI、REM-AHI、中重度REM-OSA是AMI患者MACE的危险因素;多因素Cox回归分析显示中重度REM-OSA是AMI患者MACE的独立危险因素。结论中重度REM-OSA是AMI患者MACE的独立危险因素,对此类患者应尽早诊断和干预。

Objective To analyze the clinical data of patients with acute myocardial infarction(AMI)complicated with obstructive sleep apnea during rapid eye movement(REM-OSA)and evaluate the correlation.Methods AMI patients admitted to the Provincial Hospital Affiliated to Anhui Medical University from May 2019 to January 2020 were enrolled.WatchPAT was used for sleep monitoring.Patients were divided into two groups according to Apnea hypopnea index during the rapid eye movement period(REM-AHI):moderate-severe REM-OSA(REM-AHI>15)group,no or mild REM-OSA(REM-AHI≤15)group or the control group.The clinical data and sleep date of the two groups were collected and followed up.Results The incidence of MACE in the moderate-severe REM-OSA group was higher than that in the control group,and the difference in event-free survival time was statistically significant(P<0.05).Univariate Cox regression analysis showed that BMI,REM-AHI,moderate-severe REM-OSA are risk factors for MACE in AMI patients.Multivariate Cox regression analysis shows that moderate-severe REM-OSA is an independent risk factor for MACE in AMI patients.Conclusion Moderate-severe REM-OSA is an independent risk factor for MACE in patients with AMI,such patients should be diagnosed and intervened as soon as possible.