睡眠呼吸暂停低通气综合征患者窦性心率震荡的变化

The Changes of Heart Rate Turbulence in Patients With Sleep Apnea-Hypopnea Syndrome

目的:了解睡眠呼吸暂停低通气综合征(SAHS)患者窦性心率震荡的变化。方法:对75例患者进行整夜(>7 h)多导睡眠仪监测,同时同步进行24 h动态心电图检查。根据多导睡眠仪监测结果得出睡眠呼吸暂停低通气指数(AHI),分别作出有无SAHS的诊断,将研究对象分为SAHS组(AHI≥5,n=52)与对照组(AHI<5,n=23),比较两组患者窦性心率震荡参数—震荡初始值(TO)、震荡斜率值(TS)的变化。结果:SAHS组较对照组震荡斜率值明显下降,差异有统计学意义(P<0.01)。两组震荡初始均值均<0,SAHS组>对照组,但差异无统计学意义,SAHS组24 h室性早搏的数量高于对照组,但差异无统计学意义。结论:SAHS组与对照组相比存在窦性心率震荡减弱现象,表明SAHS患者自主神经功能受损,震荡斜率降低可能作为预测SAHS患者发生心血管事件的一项指标。

Objective：To investigate the changes of heart rate turbulence （HRT）in patients with sleep apnea-hypopnea syndrome （ SAUS）. Methods： A total of 75 patients with clinically suspected SAHS were examined by overnight polysomnography and simultane- ous Hoher monitoring. According to apnea-hypopnea index （AHI）, the patients were assigned to two groups, SAHS group, AHI ≥ 5, n = 52 and Control group, AHI〈5, n=23. The turbulence onset（ TO ） and turbulence slope （TS） were evaluated and com- pared between two groups. Results：The TS in SAHS group was significantly lower than that in Control group, P〈0. 01. Both groups had TO 〈0, and SAHS group was a little higher than Control group but no statistical meaning. The number of ventricular premature contraction in SAHS group was a little more than that in Control group with no statistic meaning. Conclusion：Compared with Control group, SAHS patients has diminished HRT phenomenon, which imphes they may have damaged cardiac autonomic activity ,while decreased TS might be an indicator for cardiovascular event in SAHS patients.