阻塞性睡眠呼吸暂停低通气综合征对飞行人员心电稳定性的影响

Myocardial Electrophysiological Stability in Aviators with Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨飞行人员阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者心率变异性(heart rate variability,HRV)和QT离散度(QT dispersion,QTd)的变化。方法通过整夜多导睡眠仪(polysomnography,PSG)监测确诊飞行人员OSAHS患者共54例,根据呼吸暂停低通气指数(apnea hypopneaindex,AHI)分为轻、中、重度,均排除心血管疾病。全部OSAHS患者和对照组均同步进行24h动态心电图(dynamic e-lectrocardiogram,DCG)监测分析HRV时域指标,并通过12导联同步心电图测量QTd。结果各组OSAHS患者HRV时域指标和QTd与对照组比较,差异有统计学意义(P<0.01),且各组间差异亦有统计学意义(P<0.05或0.01)。结论 OSAHS影响飞行人员的心电稳定性,表现为HRV和QTd明显异常,并与OSAHS病情严重程度相关,在健康鉴定时应予以高度重视。

Objective To investigate the impact of obstructive sleep apnea hypopnea syndrome（OSAHS） on the heart rate variability（HRV） and QT dispersion（QTd） in military aviators.Methods A total of 54 military aviators with OSAHS and 20 healthy aviators were monitored by Overnight polysomnography（PSG） and dynamic electrocardiogram（DCG）.Time-domain indices of HRV were obtained from DCG.OSAHS aviators were divided into three subgroups（mild,moderate and severe） according to the apnea hypopnea index（AHI）.QTd was measured by synchronous 12-lead electrocardiogram.Results All OSAHS subgroups showed significant changes in time-domain indices of HRV and QTd compared with the healthy subjects（P0.01） and the difference between different subgroups was significant（P0.05 or 0.01）.Conclusion OSAHS affects the electrophysiological stability of aviators with the manifestation of abnormal HRV and QTd,which is associated with OSAHS severity.Attention should be paid to the medical assessment of OSAHS aviators.