阻塞性睡眠呼吸暂停低通气综合征患者心功能的变化

Cardiac Function Changes of Patients with Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者心功能的变化。方法选择2015年5月至2016年5月沧州市人民医院收治的127例OSAHS患者作为研究对象,根据患者夜间呼吸暂停通气指数(AHI)分为轻度组(AHI 5~14次/h,n=41)、中度组(AHI 15~39次/h,n=47)和重度组(AHI≥40次/h,n=39),并选取40例健康体检者作为对照组,所有研究对象均接受常规超声心动图检查,比较4组对象心脏结构以及心功能的变化。结果重度组左心房内径(LAD)、左心室舒张末期后壁厚度(LVPWD)、左心室舒张末期内径(LVDD)均显著高于中度组、轻度组和对照组,中度组LAD、LVPWD、LVDD均显著高于轻度组和对照组(P<0.05);重度组、中度组、轻度组室间隔舒张末期厚度(VSD)均显著高于对照组(P<0.05);重度组左心室收缩末期内径(LVDS)显著高于对照组(P<0.05);重度组E峰/A峰、Em/Am均显著低于中度组、轻度组和对照组,中度组E峰/A峰、Em/Am均显著低于轻度组和对照组,轻度组E峰/A峰、Em/Am均显著低于对照组(P<0.05);重度组E峰/Em均显著高于中度组、轻度组和对照组,中度组E峰/Em显著高于对照组(P<0.05)。结论 OSAHS患者的心脏结构出现显著改变,左心室舒张功能显著减退,且随着患者病情程度加重而更加显著。

Objective To investigate the cardiac function changes of patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods A total of 127 OSAHS patients in Cangzhou People＇s Hospital from May 2015 to May 2016 were selected as the research objects, according to the apnea hypoventilation index（AHI）, the patients were divided into a mild group （AHI：5-14 times/h,n =41 ） ,a moderate group （15-39 times/h,n =47） and a severe group （ ≥40 times/h, n = 39）, at the same time, 40 healthy people were selected as a control group. All the objects received routine echocardiography examination, to compare the cardiac structure and cardiac function of the four groups. Results The left atrial diameter（ LAD）, left ventricular end diastolic wall thickness（LVPWI）） and left ventricular end diastolic diameter（LVDD） of the severe group were significantly higher than those of the mild group, moderate group and control group, the LAD, LVPWD and LVDD of the moderate group were significantly higher than those of the mild group and control group （P 〈 0.05 ）. The ventricular septal end diastolic thickness （VSD） of the mild group, moderate group and severe group were significantly higher than those of the control group（P 〈 0. 05 ）. The left ventricular end systolic diameter（LVDS） of the severe group were significantly higher than those of control group （P 〈 0.05 ） ; the E peak/A peak, Em/Am of the severe group were significantly lower than those of the mild group, moderate group and control group, the E peak/A peak, Em/Am of moderate group were significantly lower than those of mild group and control group, the mild group were significantly lower than those of control group （P 〈 0.05） ; the E peak/Em of the severe group were significantly higher than those of the mild group, moderate group and control group, the E peak/Era of the moderate group were significantly higher than those of the control group （P 〈 0.05）. Conclusion The cardiac structure of the OSAHS patients is significantly changed, and the left ventrieular diastolic function is obviously decreased ,which aggravates with the patient＇s disease condition worsening.