睡眠呼吸暂停低通气综合征的心电改变

Electrocardiographic changes in sleep apnea hypopnea syndrome

目的全面、系统地了解评价目前为止有关睡眠呼吸暂停低通气综合征（SAHS）心电表现的最新研究进展。方法对国内2000年1月至2010年12月和国外2005年1月至2010年12月发表的有关SAHS心电研究的文献进行回顾性分析。结果SAHS患者的心率可增加，心率变异性却降低，引发各种复杂心律失常的概率明显增加，是引起心绞痛、心肌缺血，甚至急性心肌梗死，导致急性冠脉综合征，心源性猝死的重要危险因素和诱因。SAHS患者的心律失常呈阵发性，往往发生在呼吸暂停期间和睡眠时，较常见的是窦性心动过缓、窦性停搏、频发房早和房室传导阻滞。结论从目前的研究来看，SAHS的心电改变虽然没有特异性，但仍有可循的规律；SAHS的病因较复杂，其心电改变的确切机制尚无定论，需多加强基础性研究，重视并组织实施多中心、大样本、前瞻性随机对照研究。

Objective We attemp to comprehensively and systematically investigate the latest research progress of the ECG performance in sleep apnea hypopnea syndrome （SAHS）. Methods Articles on the study of SAHS published in major journals of china from Jan. 2000 to Dec. 2010 and Pubmed articles from Jan. 2005 to Dec. 2010 were retrospectively analyzed. Results SAHS can increases the heart rate, but it reduces the heart rate variability. The probability of various complicated arrhythmia significantly increased, and SAHS is an important risk factors and incentive which can cause angina, myocardial ischemia, acute myocardial infarction and acute coronary syndrome. The arrhythmia in SAHS patients is often paroxysmal, and it often occurs during sleep or the apnea. The more common kinds of arrhythmia is sinus bradycardia, sinus arrest, frequent atrial premature beats and atrioventricular block. Conclusions Judging from the current research, we conclude that the ECG changes of SAHS patients have no specific, but it still have some rules to follow. The etiology of SAHS is more complex, and the exact mechanism about the ECG changes have not be resolved. We needs more stronger basic research, and the implementation of large sample, multicenter, prospective randomized study should be pay more attention to.