阻塞性睡眠呼吸暂停低通气综合征与心血管结构改变关系分析

Analysis of relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular structure change

目的:通过超声心动图及血管彩色多普勒观察阻塞性睡眠呼吸暂停综合征(OSAHS)患者心脏及血管结构的改变情况,探讨OSAHS严重程度对心血管结构的影响。方法:将经多导睡眠图检测的100例受试对象,根据呼吸暂停低通气指数分为对照组40例、OSAHS轻中度组40例、OSAHS重度组20例,应用超声心动图及血管彩色多普勒超声显像仪观察心脏结构及颈动脉内膜中层厚度。结果:OSAHS组室间隔厚度、左心室舒张期内径(LVDd)、舒张末期左心室后壁厚度(LVPWTD)、左心房内径(LAD)、主动脉内径、主动脉血流速度、颈动脉内膜中层厚度比对照组增大(P<0.05),且LVDd、LVPWTD、LAD的增大与OSAHS的严重程度相关(P<0.05)。重度OSAHS组左心室射血分数较对照组下降(P<0.05),轻中度组下降不明显。结论:OSAHS导致心脏及血管内膜的结构改变,随着OSAHS的程度加重心脏及血管内膜结构改变加重,超声心动图及血管彩色多普勒超声检查可作为治疗OSAHS疗效的观察方法。

Objective： To observe changes in the structure of heart and blood vessels of patients with obstructive sleep apnea hypopnea syndrome（ OSAHS） by echocardiography and color Doppler sonography. To explore OSAHS severity influence on cardiovascular structures. Methods： According to the apnea hypoventilation index（ AHI）,by polysomnography（ PSG）,100 subjects were divided into 3 groups： 40 cases without OSAHS as normal control,40 cases with mild-to-moderate OSAHS,20 cases with severe OSAHS. Cardiac structure indexs were observed by echocardiography and carotid intima- media thickness was observed by color Doppler sonography. Results： The indicators such as interventricular septum thickness and left ventricular diastolic diameter（ LVDd）,left ventricular posterior wall thickness diastolic period（ LVPWTD）,left atrium diameter（ LAD）,aortic diameter,aortic blood flow velocity,carotid intima-media thickness in OSAHS group were higher than those of the normal control group（ P 〈0. 05）,and the increase of LVDd,LVPWTD,LAD was related with OSAHS severity. Left ventricular ejection fraction of severe OSAHS group was lower than that of normal control group（ P 〈0. 05）,differently,that of mild-tomoderate OSAHS group had not significant decline. Conclusion： OSAHS leads to heart and arteries endangium structure change,and the degree of heart and arteries endangium structure change is related with OSAHS severity.Examination by echocardiography and arteries color Doppler sonography can be used as observation methods during treatment of OSAHS.