女性阻塞性睡眠呼吸暂停综合征患者心律失常及心率变异性分析

Change of Rate Variability and Arrhythmia in Women Patients with Obstructive Sleep Apnea Syndrome

目的分析女性阻塞性睡眠呼吸暂停综合征（Obstructive Sleep Apnea Syndrome，OSAS）患者心率变异性（hearttatevariability HRV）和心律失常的情况。方法选择67例女性OSAS患者，另选25例女性健康对照组，所有受试对象均进行多导睡眠和动态心电图监测，分析比较两组昼夜心率变异时域和频域差异，和不同时段心律失常情况。结果（1）OSAS组和对照组对比，夜间24h每5min窦性R—R间期均值标准差（SDANN），昼夜低频功率升高，HF夜、RMSSD夜降低。②OSAS患者的心律失常以窦性心动过缓（89．3％）、窦性心动过速（63．1％）、室性早搏（46．1％）常见。不同时段的心律失常提示凌晨3：00—4：00为心律失常高发时段（P〈0．05）。结论OSAS女性患者昼夜交感神经状态：夜间迷走神经活性减低、交感与迷走神经失衡；心律失常以凌晨3：00—4：00高发，以窦性心动过缓、窦性心动过速、室性早搏多见。

Objective To study the change of Rate Variability and the frequency and numbers of arrhythmia in patients with obstructive sleep apnea syndrome. Methods Totally 67 OSAS and 25 volunteers without OSAS. All participants underwent polysomnography（PSG）,24 -hour Hoher - ECG. All the frequency- domain mad time- domain parameters of HRV were calculated according to daytime（d） and nighttime （n）for analyses collect the number of arrhythmia in different time slots at night Meanwhile. Results SDANNd/n, LFd/n were significanthy higher in OSAS groups when camparing with volunteers （P 〈 0. 05 ）. HFn, rMSSDn were significanthy lower in OSAS groups canaparing with volunteers （ P 〈 O. 05 ）. There was an abvious difference in the OSAS patients in different time slots at night regarding the numbers of arrhythmia （P 〈 0. 05）. This time is during 3 ： 00 - 4 ： 00. Arrhythmia was a common complication in the patients with OSAS, sinus bradycardia and ventricalar prematere beats were the more likely happened. Conclusion OSAS may increase the activity of aympathetic nerve sysem, it may decrease the activity of vagus nerve system at night. Deteriorate the balance between sympathetic and Vagus nerve system, the numbers of arrhythmia in different time slots at night in which the peak period is 3：00 -4：00 sinus bradycardia is the most likely happened.