不同程度阻塞性睡眠呼吸暂停综合征患者左心室结构与功能变化的相关性研究

Study on the correlation of left ventricular structure and function changes in obstructive sleep apnea syndrome patients with different degrees

目的:研究阻塞性睡眠呼吸暂停综合征(OSAS)患者的左心室结构和功能的变化情况,同时分析其结构功能指标与病情严重程度的相关性。方法:选取我院2014年9月至2017年1月,收治的OSAS患者120例作为观察组,并根据患者病情分为轻度OSAS组、中度OSAS组和重度OSAS组,分别为43例、38例和39例,选取同时期我院门诊体检检查健康者40例作为对照组,所有研究对象均接受常规超声心动图和颈动脉超声检查。对比各组研究对象的超声心动图和颈动脉超声检查结果参数,采用Pearson相关性分析OSAS患者左心室结构与功能的相关性。结果:观察组患者的LVSd、LVDd、LVPWT、IVST、LVMI、EDT、A峰、PA、AO、DC、CC、Dis、IMT等指标均显著高于对照组(P<0.01),且随着患者病情严重程度的增加(P<0.01);同时观察组的LVEF、E峰以及E/A比值显著低于对照组(P<0.01),且随着病情严重程度的增加(P<0.01);Pearson相关性分析显示,LVEF、LVMI与其LVSd、LVPWT、IVST、A峰等指标均呈明显正相关(P<0.01),与其E峰以及E/A比值等指标均呈明显负相关(P<0.01)。结论:中重度OSAS患者的左心室结构可发生明显的向心性肥厚,同时左心室舒缩功能显著下降,患者病情有进一步恶化的趋势,并与患者的左心室结构改变有一定相关性。

Objective： To investigate the changes of left ventricular structure and function in patients with obstructive sleep apnea syndrome（ OSAS）,and to analyze the correlation between the severity and the severity of the disease. Methods： in our hospital from September 2014 to January 2017 were 120 OSAS patients as the observation group,and according to the condition of patients were divided into mild OSAS group,moderate OSAS group and severe OSAS group were 43 cases,38 cases and 39 cases,select the same period in our hospital out-patient medical examination of 40 cases of healthy subjects as control group. All subjects underwent routine echocardiography polysomnography and carotid ultrasound examination. The echocardiographic parameters and the result of carotid ultrasonography in each group were compared,and the correlation between the left ventricular geometry index and the condition of the patients with OSAS was analyzed. Results： the observation group of patients with LVSd,LVDd,LVPWT,IVST,LVMI,EDT,PA,AO,A peak,DC,CC,Dis and IMT were significantly higher than those in the control group（ P〈0.01）,and with the increase of severity of the disease（ P〈0.01） severe,patients in group OSAS were significantly higher than those in moderate OSAS group（ P〈0.01）; and the observation group LVEF,E peak and the ratio of E/A was significantly lower than the control group（ P〈0.01）,and increased with the severity of the disease（ P〈0.01）. The correlation analysis of Pearson showed that there was a significant positive correlation between LVEF Pearson and LVSd T LVPWTTIVSTA peak（ P〈0.01）,but a significant negative correlation with E peak and E/A ratio（ P〈0.01）. Conclusion： left ventricular structure in patients with severe OSAS can obviously centripetal hypertrophy,and left ventricular systolic and diastolic function decreased significantly in patients with worsening trend,and there is a certain correlation with the changes of left ventricular structure in patients with severity.