不同严重程度OSAHS患者心律失常及高血压发生情况分析

Analysis of arrhythmia and hypertension in OSAHS patients with different severity

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与心律失常及高血压的关系。方法选取2014年3月-2016年2月于抚顺市矿务局总医院由多导睡眠图（PSG）检查确诊为OSAHS患者104例,其中男性63例,女性41例;年龄38-67岁,平均年龄（51.91±9.78）岁。观察不同严重程度OSAHS患者发生心律失常（短阵室上性心动过速、房室传导阻滞等）及高血压发生情况。结果 104例OSAHS患者,其中轻度OSAHS患者51例,其中男性30例,女性21例,平均年龄（50.21±9.28）岁;中度OSAHS患者21例,其中男性13例,女性8例,平均年龄（51.73±11.63）岁;重度OSAHS患者32例,其中男性20例,女性12例,平均年龄（52.09±10.43）岁;不同程度OSAHS患者年龄、性别等比较差异无统计学意义（P〉0.05）;重度OSAHS组收缩压和舒张压明显高于轻度和中度OSAHS组（P〈0.05）;中度OSAHS组收缩压和舒张压明显高于轻度OSAHS组（P〈0.05）;重度OSAHS组中单纯伴高血压和心律失常的发生比例分别为46.88%和46.88%,明显高于轻度OSAHS患者（P〈0.05）;重度OSAHS组中高血压合并心律失常的比例为28.13%,明显高于其他组（P〈0.05）;重度OSAHS组短阵室上性心动过速（SVT）、窦性停搏（SA）、二度Ⅰ型房室传导阻滞（AVB）和二度Ⅱ型AVB发生比例分别为15.63%、12.50%、25.00%和14.29%;中度OSAHS组SVT、SA、二度Ⅰ型AVB和二度Ⅱ型AVB发生比例分别为14.29%、9.52%、9.52%和14.29%;轻度OSAHS组仅有3.29%的患者发生二度Ⅰ型AVB。结论不同程度OSAHS患者心律失常及高血压的发生比例有所不同,其中重度SAHS患者心律失常及高血压的发生比例较高,应给予高度重视。

Objective To investigate the relationship between obstructive sleep apnea hypopnea syndrome（OSAHS） and arrhythmia and hypertension. Methods 104 OSAHS patients in The General Hospital of Bureau of Mines from March 2014 to February 2016 were enrolled, including 63 males and 41 females, aged 38 to 67 years, mean age（51.91±9.78） years. Arrhythmia（paroxysmal supraventricular tachycardia, atrioventricular block, etc.） and the occurrence of hypertension in OSAHS patients with different severity were observed. Results Among the 104 OSAHS patients, there were 51 patients with mild OSAHS, including 30 males and 21 females with a mean age of（50.21±9.28） years; 21 patients with moderate OSAHS, including 13 males and 8 females with a mean age of（51.73±11.63） years old; 32 patients with severe OSAHS, including 20 males and 12 females with a mean age of（52.09±10.43） years. There were no significant differences in the age and sex of OSAHS patients（P〈0.05）. The systolic and diastolic blood pressure of severe OSAHS group were significantly higher than those of mild and moderate OSAHS group（P〈0.05）. The levels of systolic and diastolic blood pressure in moderate OSAHS group were significantly higher than those in mild OSAHS group（P〈0.05）. The incidence of hypertension and arrhythmia in OSAHS group was 46.88% and 46.88%, respectively, which was significantly higher than that in mild OSAHS patients（P〈0.05）. The proportion of hypertensive patients with arrhythmia in OSAHS group was 28.13%, which was significantly higher than that in other groups（P〈0.05）. The incidence of supraventricular tachycardia（SVT）, sinus arrest（SA）, Ⅱ atrioventricular block（AVB）and Ⅱ°Ⅱ AVB in severe OSAHS group were 15.63%, 12.50%, 25.00% and 14.29% respectively. The incidence of SVT, SA, Ⅱ°Ⅰ type AVB and Ⅱ°Ⅱ type AVB in moderate OSAHS group were 14.29%, 9.52%, 9.52% and 14.29%, respectively. In mild OSAHS group, only 2.29% of patients developedⅡ°Ⅰ type AVB. Conclusion Different degrees of OSAHS patients with arrhythmia and the incidence of hypertension is different, in which severe SAHS patients with arrhythmia and high incidence of hypertension should be given high priority.