合并长R-R间歇的心房颤动与阻塞性睡眠呼吸暂停综合征的相关性

Association of atrial fibrillation with long R-R intervals with obstructive sleep apnea syndrome

目的:研究心房颤动(房颤)患者长R-R间歇与阻塞性睡眠呼吸暂停综合征(OSAS)发生的相关性。方法:收集我院门诊或住院就诊的126例房颤患者,同时行动态心电图(Holter)及夜间睡眠呼吸监测。根据Holter中是否伴有长间歇(>2.5 s)分为两组,比较两组病例睡眠参数,并行高危因素分析。结果:126例房颤患者分为房颤伴长间歇组(38例)和房颤无长间歇组(88例),两组年龄、性别、体质量指数(BMI)、吸烟史及合并症间的差异均无统计学意义(P>0.05)。其中,合并OSAS患者有67例,房颤伴长间歇组的发生率为71.1%(27/38),房颤无长间歇组的发生率为45.5%(40/88),两组差异有统计学意义(P<0.05)。房颤伴长间歇组的呼吸暂停低通气指数(AHI)、最长呼吸暂停时间平均值分别为(16.1±12.1)次/h、(20.0±12.3)s,房颤无长间歇组相应平均值分别为(7.4±5.6)次/h、(8.2±4.7)s,两组差异有统计学意义(P<0.05)。Pearson相关分析表明,OSAS、AHI均与房颤长间歇发生相关(P<0.05)。多因素logistic回归分析表明,AHI是房颤长间歇发生的独立危险因素。结论:合并长R-R间歇的房颤患者OSAS的发生率较高,AHI的增高可以预测房颤长间歇发生。

Objective： To study the association of atrial fibrillation （AF） with long R-R intervals with obstructive sleep apnea syndrome（OSAS）. Methods： A total of 126 AF patients were enrolled and evaluated for Holter and polysomnography examination. All patients were divided into two groups according to whether long R-R intervals （more than 2.5 seconds） occurred or not. Results： One hundred and six AF patients were divided into case group （38 cases） and control group （88 cases）. There were no statistical significance difference between the age, gender, body mass index（BMI） , smoking history, and complications of the 2 groups（P 〉 0.05）. The incidence of OSAS in case group was 71.1% （27/38）, which was higher than that of the control group [45.5% （40/88）,P 〈 0.05 ]. Apnea hypopnea index（AHI） was （ 16.1 Э 12.1 ） times/h and longest apnea time （20.0 Э 12.3 ） seconds respectively in case group, which was higher than in control group （P 〈 0.05）. Pearson correlation analysis showed that OSAS and AHI were associated with incidences of long R-R intervals in atrial fibrillation （ P 〈 0.05 ）. Muhivariable logistic re- gression analysis showed that AHI was an independent risk factor for long intervals in atrial fibrillation . Conclusion： There is a high incidence of OSAS in atrial fibrillation patients combination with long R-R in-tervals. A higher AHI value could predict an increase in the incidence of long intervals in atrial fibrillation.