阻塞性睡眠呼吸暂停低通气综合征与心肌缺血及心律失常的关系

Relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular disorders in adult snorers

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与心肌缺血及心律失常的关系.方法 对162例打鼾者进行夜间7h以上多导睡眠监测（PSG）,长程心电图（Holter）同步记录心电动态变化.根据PSG结果分为OSAHS组128例和对照组34例,比较组间呼吸暂停低通气指数（AHI）、最长呼吸暂停时间（LAT）、平均呼吸暂停时间（MAT）、最低动脉血氧饱和度（mSaO2）、心肌缺血、心律失常发生率及发生类型.结果 OSAHS组心肌缺血及心律失常的发生率明显高于对照组（P＜0.05）,并且随着病情加重而升高（P＜0.05）.结论 OSAHS与心肌缺血及心律失常关系密切,OSAHS患者夜间心律失常与低氧血症密切相关,OSAHS是导致心血管疾病及增加心血管意外的重要危险因素.

Objective To investigate the relationship between obstructive sleep apnea hypopnea syndrome （OSAHS） andcardiovascular disorders including myocardial ischemia and cardiacarrhythmia.Methods With the use of polysomnography,162 adult snorers were examined with 7-hour nocturnal monitoring and divided into the OSAHS group （n =128） and the non-OSAHS group （n =34）.Using ambulatory electrocardiogram,ambulatory electrocardiac variability was monitored and compared between the two groups.The following parameters including apnea hypopnea index （AHI）,longest apnea time （LAT）,mean apnea time （MAT）,minimum arterial oxygen saturation （mSaO2）,myocardial ischemia,and the incidence and types of arrhythmias were compared respectively in two groups.Results This study demonstrated that there was a significantly higher incidence of myocardial ischemia and cardiac arrhythmias in patients with OSAHS （P ＜ 0.05）,which also showed an increased incidence with aggravation of the disease condition.Conclusions The results of this research suggested that there was a close relationship between the development of OSAHS andmyocardial ischemia and cardiac arrhythmia.Further more,occurrence of norcturnal arrhythmia was related to hypoxemia.So OSAHS was an important risky factor for developing cardiovascular diseases.