冠心病患者中冠脉血管狭窄程度与睡眠呼吸暂停低通气指数及嗜睡的相关性

Correlation between sleep-disordered breathing and sleepiness in patients with coronary heart disease

目的通过使用便携式睡眠呼吸监测仪对冠状动脉粥样硬化性心脏病(冠心病)患者的睡眠呼吸情况进行流行病学调查并探讨睡眠呼吸障碍、嗜睡及冠心病之间相关性。方法对2015年10月~2016年10月于安阳市人民医院心内科行冠状动脉造影的确诊为冠状动脉粥样硬化性心脏病(冠心病)患者120例进行便携式睡眠呼吸监测,根据冠状动脉造影结果评估冠状动脉血管狭窄程度、嗜睡量表了解嗜睡情况、睡眠呼吸监测计算吸暂停及低通气次数,并对三者之间的关系进行统计学分析分析。结果在120例确诊的冠心病患者中,无睡眠呼吸暂停综合征者44例(36.7%),轻度组45例(37.5%),中重度组31例(25.8%)。患有中重度睡眠呼吸暂停综合征的冠心病患者中,其冠状动脉狭窄程度Gensini评分明显高于轻度睡眠呼吸暂停综合征及对照组的患者,Gensini评分分别为113.63±30.63,83.22.98±23.87,64.66±15.96(P均<0.01);根据嗜睡量表分为嗜睡组及非嗜睡组,在中重度睡眠呼吸暂停综合征患者中,年龄、体质指数(BMI)及冠状动脉狭窄程度Gensini评分在嗜睡组明显高于非嗜睡组(P均<0.05)。睡眠呼吸暂停低通气指数(AHI)、冠脉血管狭窄严重程度Gensini评分及嗜睡Epworth评分以及两两相关。其中,AHI与Gensini评分相关系数为0.75(P<0.05)。结论在冠心病患者中,中重度睡眠呼吸暂停综合征患者的嗜睡评分及冠状动脉狭窄程度高于轻度组及对照组。冠心病患者冠状动脉血管狭窄严重程度Gensini评分与AHI、及嗜睡Epworth评分呈正相关。

Objective The epidemiological investigation of sleep-breathing status in patients with coronary heart disease in the People＇s Hospital of Anyang was conducted using a portable sleep-breathing-respiratory monitor and the correlation between sleep-disordered breathing, sleepiness and coronary heart disease was explored. Methods A portable sleep-respiratory monitoring was performed on 120 patients with coronary heart disease diagnosed by coronary angiography at the Department of Cardiology, People＇s Hospital of Anyang from October 2015 to 2016. According to coronary angiography results to assess the degree of coronary artery stenosis, sleepiness scales to understand sleepiness, sleep apnea monitoring to calculate the number of apnea and hypoventilation, and the statistical analysis of the relationship between the three. Results Among the 120 patients diagnosed with coronary heart disease, 44（36.7%） had no sleep apnea syndrome, 45（37.5%） were mild, and 31（25.8%） were moderate and severe. The Gensini score was significantly higher in patients with moderate-severe sleep apnea syndrome than those in the non-moderate-severe group（Gensini score 113.63±30.63 vs. 83.22.98±23.87, P〈0.019）. According to the sleepiness scale, the sleepiness group was divided into the sleepiness group and the non-sleepiness group. In the patients with moderate to severe sleep apnea syndrome, the age, body mass index（BMI）, and degree of coronary stenosis Gensini were significantly higher in the sleepiness group than in the non-sleepiness group（P〈0.05）. Sleep apnea hypopnea index AHI, coronary stenosis severity Gensini score and sleepiness Epworth score, and two-two correlations. Among them, the correlation coefficient between AHI and Gensini score was 0.75（P〈0.05）. Conclusion Sleep apnea syndrome may be another independent risk factor for coronary heart disease.