阻塞性睡眠呼吸暂停低通气综合征与房颤的相关性研究

Association of atrial fibrillation and obstructive sleep apnea

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与房颤的相关性。方法:通过Berlin问卷调查,对1800例睡眠障碍患者进行OSAHS诊断和分析,同时进行心电图检测;随机抽取60例患者进行多导睡眠图(PSG)检测,以评价其敏感性和特异性。另外选取在我院进行体检的企事业单位自然人群1500人进行整群抽样调查,采用国际通用的标准化调查方法,在人群中进行以房颤为主要内容的心血管流行病学调查并统计结果。结果:OSAHS组和对照组间在年龄、性别、体质指数、糖尿病以及高血压患病率差异无统计学意义(P>0.05)。Berlin问卷调查结果显示敏感性为0.86,特异性为0.89。OSAHS组的房颤患病比例明显高于对照组(7.4%vs3.8%,P=0.000)。房颤和OSAHS的相关性比值比为1.87(95%CI为1.27～2.81,P=0.002)。结论:OSAHS和房颤间存在高度的相关性,OSAHS患者中房颤患病比例明显高于正常人群,房颤在OSAHS患者中的高流行为临床上OSAHS和房颤的治疗提供新思路。

Objectives To investigate the association between obstructive sleep apnea （OSAHS） and atrial fibrillation （AF）. Methods OSAHS was diagnosed with the validated Berlin questionnaire （n = 1 800） and examined with electrocardiogram. And the diagnostic accuracy and sensitivity was assessed by polysomnography in 60 randomly chosen patients. 1 500 randomly selected individuals were examined with electrocardioversion for AF diagnosis （n = 1 500）. Logistic regression modeled the association of AF and OSAHS for relevant covariates. Results Patients in each group had similar age, gender, body mass index, and rates of diabetes, hypertension （P 〉 0.05）. The questionnaire performed with 0.86 sensitivity, 0.89 specificity in our sample. The proportion of patients with OSA was significantly higher in the OSAHS group than in the control group （7.4% versus 3.8%, P = 0.000）. The adjusted odds ratio for the association between AF and OSAHS was 1.87 （95% CI 1.27 to 2.81, P = 0.002）. Conclusions The novel finding of this study is that a strong association exists between OSAHS and AF, such that AF is strikingly more prevalent in patients with OSAHS than in control group. The high epidemicity of AF in OSAHS patients underscore the clinical importance of these results.