阻塞型睡眠呼吸暂停低通气综合征与冠心病的相关性研究

Study on the relationship between obstructive sleep apnea hypoventilation syndrome and coronary artery disease

目的：阻塞型睡眠呼吸暂停低通气综合征（OSAHS）与冠心病（CAD）关系密切,但国内尚缺乏相关的统计学数据,本研究旨在探讨OSAHS与CAD的相关关系。方法：收集2007年4月—2007年12月以冠心病或胸痛原因待查,同意进行冠状动脉造影及睡眠呼吸监测的患者共126例,生化检查血脂,对其结果进行分析。结果：冠状动脉造影确诊CAD 100例,经多导睡眠图（PSG）监测CAD组合并OSAHS患者56例（56.0%）。冠状动脉造影正常的非CAD26例,经PSG监测确诊OSAHS患者8例（30.8%）。CAD组OSAHS发生率高于冠状动脉造影正常组（P〈0.05）。Logistic回归分析显示校正年龄、吸烟、高血压病、糖尿病等危险因素后,睡眠呼吸暂停低通气指数（AHI）≥20次/小时为CAD发病的危险因素,OR=4.458,95%CI为1.211-16.414,P〈0.05。结论：CAD合并OSAHS的发生率高,OSAHS可能是CAD发病的危险因素。对CAD患者应常规进行睡眠呼吸监测,及早发现睡眠呼吸障碍性疾患并对其进行及时合理的治疗,提高CAD患者的生存质量,改善预后。

Objective：Obstructive sleep apnea hypoventilation syndrome（OSAHS） is associated with coronary artery disease（CAD）.There was less statistical data about it in China.The objective of this study is to investigate the relationship between OSAHS and CAD.Methods：One hundred and twenty-six consecutive inpatients coronary angiography and polysomnography were performed from April 2007 to December 2007.Serum levels of cholesterol,triglyceridemia,highdensity lipoprotein and lowdensity lipoprotein were investigated.Results：One hundred patients were diagnosed as CAD and 26 patients were excluded CAD.The prevalence of OSAHS in patients with CAD was higher than those with no CAD,respectively 56%（56/100） and 30.8%（8/26）.In multiple logistic regression model,the risk of CAD in patients with AHI≥20 is 4.458 times than that in patients with AHI〈20 after emendating the risk factors such as age,smoking,hypertension and diabetes（OR=4.458,95% CI 1.211-16.414）.Conclusion：There is high prevalence of OSAHS in patients with CAD,OSAHS is the possible risk of CAD.Sleep-breath monitor should be performed in patients with CAD.