阻塞性睡眠呼吸暂停综合征昼夜心率变异性的变化

The alteration of day-night character of heart rate variability in obstructive sleep apnea syndrome

目的 研究阻塞性睡眠呼吸暂停综合征对昼夜心率变异性的影响。方法 2 1例不伴有高血压、糖尿病和冠心病的阻塞性睡眠呼吸暂停综合征患者 (OSAS组 )及 2 5例正常对照者 (对照组 )分别于多道睡眠监测后行 2 4h心电图检查。对 0 9∶0 0～ 12∶0 0 (上午 )、15∶0 0～ 18∶0 0 (下午 )、0 0∶0 0～ 0 6∶0 0 (睡眠 )及全天 2 4h的心率变异性进行时域、频域分析。结果 阻塞性睡眠呼吸暂停综合征的患者PNN5 0、rMSSD在 0 9∶0 0～ 12∶0 0、15∶0 0～ 18∶0 0、0 0∶0 0～ 0 6∶0 0及全天分别为 3 0 0± 3 95、6 19± 8 6 3、18 0 2± 2 0 6 6、7 71±9 0 0 [PNN5 0 (% ) ],19 81± 11 98、31 6 7± 2 6 98、4 9 76±4 6 88、35 86± 32 6 4 [rMSSD(ms) ];均较对照组相应时段的测量值为高 (P均 <0 0 5 ) ,其中对照组PNN5 0 (% )分别为0 33± 0 4 3、0 4 0± 0 5 4、1 97± 2 95、0 80± 1 19,rMSSD(ms)分别为 15 30± 3 2 7、15 0 0± 5 2 2、18 33± 7 17、17 6 0± 3 6 3。夜间OSAS组的SDNN、SDANN也分别较对照组为大 [SDNN (ms)分别为 89 30± 2 8 34、5 3 5 0± 2 1 0 9,P =0 0 0 0 ;SDANN(ms)分别为 39 14± 13 2 4、2 9 10± 10 88,P=0 0 0 8];而在 0 9∶0 0～ 12∶0 0时段OSAS?

Objectives To study the alteration of the day-night character of heart rate variability(HRV) in patients with obstructive sleep apnea syndrome(OSRS).Methods 21 patients with OSAS and 25 healthy people were divided into OSAS group and control group respectively. All individuals had no hypertension, diabetes and coronary artery diseases. 24-hour dynamic electrodcardiogram the HVR of the period of 09∶00～12∶00,15∶00～18∶00,00∶00～06∶00 and the whole 24 hours were Recorded and analyzed. Results PNN50 and rMSSD during 09∶00～12∶00,15∶00～18∶00,00∶00～06∶00 and the whole 24 hour were 3.00±3.95、6.19±8.63、18.02±20.66、7.71±9.00(%) and 19.81±11.98,31.67±26.98,49.76±46.88,35.86±32.64 (ms) in OSAS group, and were significantly higher than that of control group respectively [PNN50(%)0.33±0.43,0.40±0.54,1.97±2.95,0.80±1.19;rMSSD(ms):15.30±3.27,15.00±5.22,18.33±7.17,17.60±3.63]. In OSAS group,SDDN(ms) and SDANN(ms) were higher than control group respectively(SDNN:89.30±28.34 vs 53.50±21.09,P=0.000;SDANN:39.14±13.24 vs 29.10±10.88,P=0.008) during 00∶00～06∶00; but SDANN was lower than that of control group during 09∶00～12∶00(40.88±12.08 vs 51.90±18.77,P=0.021). Comparing the values among the periods of 09∶00～12∶00,15∶00～18∶00 and 00∶00～06∶00,in control group,PNN50 was higher(F=7.000,P=0.002) and SDANN was lower(F=15.767,P=0.000) in 00∶00～06∶00; and in control group,SDNN,rMSSD and HFnor were significantly higher(F=9.018、4.670、3.268;P=0.000,0.013,0.045 respectively) and were lower(F=3.268,3.943;P=0.045,0.025 respectively) in 00∶00～06∶00.Conclusions In OSAS patients without hypertension,diabetes and coronary heart disease, the day-night character of HRV is changed.