阻塞型睡眠呼吸暂停低通气综合征夜间不同时段呼吸暂停低通气次数与心律失常发生规律相关性研究

Regularity of apnea hypopnea and arrhythmia frequencies in OSAHS patients in different time slots at night

目的探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者夜间不同时段发生呼吸暂停、低通气次数与心律失常次数及规律相关性。方法选择2006年5～12月在兰州大学第一医院就诊经多导睡眠图监测确诊的69例OSAHS男性患者,根据呼吸紊乱指数(AHI)分为轻度(16例)、中重度(52例)2组。收集其夜间不同时段发生呼吸暂停、低通气次数及心律失常次数和AHI、平均血氧饱和度(MSpO2)、最低血氧饱和度(LSpO2)。比较上述指标之间的差异并分析相互间的关系。结果OSAHS患者夜间不同时段发生呼吸暂停、低通气和心律失常次数有着明显的不同;中重度OSAHS患者在凌晨>3时至4时发生的呼吸暂停、低通气和心律失常次数明显高于其他时段(P<0.05),并与MSpO2和LSpO2呈负相关(P均<0.05);心律失常总次数与凌晨>3时至4时和>4时至5时发生的呼吸暂停、低通气次数呈线性回归关系(F=27.1,P=0.001)。结论中重度OSAHS患者夜间不同时段发生呼吸暂停、低通气次数和心律失常次数有着明显的规律性,尤其以凌晨>3时至4时为其高峰时段。

Objective TO study the apnea hypopnea frequency and numbers of arrhythmia in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） in different time slots at night and their correlation. Methods The patients were divided into 2 groups according to the apnea-hypopnea index（AHI） ：mild group（ n = 16）, moderate and severe group （n = 52）. A total of 69 OSAHS patients were selected. Collect their apnea hypopnea frequency and the numbers of arrhythmia（PSG） in different time slots at night. Meanwhile,the AHI, the lowest SpO2 （LSpO2 ） and mean values of SpO2 （ MSpO2 ） were collected. Compare the differenes between these indicators and analyze their relationship. Results There was an obvious difference in the OSAHS patients in different time slots at night regarding apnea hypopnea frequency and the numbers of arrhythmia（ P 〈 0.05 ）. The moderate to severe OSAHS patients had apnea hypopnea and arrhythmia significantly more often than in other periods during the 〉3：00 - 4：00 am time slot,which was negatively related to LSpO2 and MSpO2 （ P 〈 0. 05 ）. The numbers of arrhythmia were in multiple linear regression with the apnea hypopnea frequency during the 3：00 -3：59 am time slot and 〉4：00 -5：00 am time slot（F =27.1 ,P =0.001 ）. Conclusion There is a clear regularity in the moderate to severe OSAHS patients regarding apnea hypopnea frequency and the numbers of arrhythmia in different time slots at night,in which the peak period is 〉 3：00 -4：00 time slot. The older the patients are, the more severe the OSAHS is,the more significant this correlation is.