睡眠呼吸暂停综合征与心电稳定性的关系研究

Relationship between sleep apnea syndrome and cardiac electrical stability

目的:评估睡眠呼吸暂停综合征(SAS)对心电稳定性的一些常用指标,如心率变异性(HRV)、窦性心率震荡(HRT)、T波电交替(TWA)、心率校正后的QT间期(QTc)等的影响。方法:根据多导睡眠图(PSG)监测结果及临床表现,患者被分为两组,SAS组(n=47)和非SAS组(n=35)。并对入组患者行动态心电图检查,观察并记录两组患者心电稳定性相关指标。结果:(1)与非SAS组比较SAS患者日间的HRV无明显差异(P>0.05),但夜间HRV明显下降(P<0.01);(2)与非SAS组比较,SAS患者HRT的震荡斜率(TS)指标明显下降[(11.33±5.028)ms/RR比(6.92±4.43)ms/RR],震荡初始(TO)明显升高[(-1.39±2.18)%比(0.134±1.203)%],P均<0.001;(3)SAS患者TWA时域指标峰值与非SAS组比较无明显差异;(4)SAS患者QTc较非SAS患者明显延长[(405.29±20.63)ms比(390.37±15.69)ms,P=0.001]。结论:睡眠呼吸暂停综合征可以严重影响心电稳定性。

Objective： To assess effects of sleep apnea syndrome （SAS） on common indexes of cardiac electrical stability, including heart rate variability （HRV）, sinus heart rate turbulence （HRT）, T wave alternans （TWA） and corrected QT interval （QTc）. Methods： The patients were divided into SAS group （n=47） and non-SAS group （n=35） according to results of polysomnogram （PSG） monitoring and clinical manifestation. All patients were measured with dynamic electrocardiogram and relative indexes of dynamic electrocardiogram were observed and analyzed in two groups. Results： （i） There were no significant difference in HRV indexes during daytime between the two groups （P 〉0.05）, but HRV indexes during night in SAS group were significantly lower than those of non-SAS group （P〈 0.05） ; （2） Compared with non--SAS group, turbulence slope [TS, （11.33±5. 028） ms/RR vs. （6.92±4.43） ms/ RR] significantly decreased and turbulence onset [TO, （ - 1.39 ± 2. 18） % vs. （0. 134 ± 1. 203） %] significantly increased in SAS group, P〈0. 001 both; （3） TWA of SAS group was no significant difference compared with non- SAS group; （4） In SAS group, QTc [ （405.29±20.63） ms vs. （390.37±15.69） ms, P=0. 0011 was significantly prolonged compared with that of non-SAS group. Conclusion： SAS can seriously affect cardiac electrical stability.