心率变异性及心率减速力对阻塞性睡眠呼吸暂停低通气综合征预测价值

The value of heart rate variability and heart rate deceleration in predicting obstructive sleep apnea hypopnea syndrome

目的探讨心率变异性(HRV)及心率减速力(DC)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断指标的相关性。方法收集在我院就诊的以白日嗜睡或夜间睡眠打鼾为主诉的101例患者,根据紊乱指数(AHI)分为:对照组(AHI<5)、轻中度组(5≤AHI≤30)、重度组(AHI>30),均进行呼吸睡眠监测(PSG)及24小时动态心电图(HCG)检查,记录PSG参数及HRV指标、DC值,并进行统计学分析。结果AHI、氧减指数(ODI)、血氧低于90%以下的总时间占睡眠总时间的百分比(T90)、最低氧饱和度(SaO 2min)、全部窦性心搏RR间期的标准差(SDNN)、低频功率(LF)、高频功率(HF)及LF/HF在对照组、轻中度组及重度组间比较差异均具有统计学意义(P<0.05);SDANN、rMSSD、PNN50在重度组与轻中度组、重度组与对照组之间差异具有统计学意义(P<0.05);在OSAHS组中SDNN、LF/HF与AHI、ODI、T90具有相关性(P<0.05),DC值与AHI呈负相关(P<0.05)。结论HRV指标尤其是LF/HF及DC值对OSAHS的初筛及预后评估有重要意义。

Objective:To discuss the correlation between heart rate variability(HRV)and deceleration(DC)in obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:The subjects of 101 patients with daytime somnolence or night sleep snoring in our hospital were included and were categorized into three groups according to apnea-hypopnea index(AHI):AHI<5 as control group,5≤AHI≤30 as mild-to-moderate OSAHS group,AHI>30 as severe OSAHS group.Polysomnography(PSG)test and 24-hour dynamic electrocardiagraphic(DCG)monitoring in all patients were done and PSG parameters,HRV index and DC were recorded and analyzed.Results:Statistically significant differences were found in HRV index,such as SDNN,LF,LF and LF/HF and PSG parameters,such as AHI,ODI,T90 and SaO 2min in between groups.SDANN,rMSSD and PNN50 results revealed significant difference between control group,mild-to-moderate OSAHS group and severe OSAHS group.In the OSAHS group,SDNN and LF/HF were positively linked to AHI,ODI and T90 while DC and AHI were negatively related.Conclusion:HRV index especially LF/HF and DC are important for assessing the prognosis and detecting OSAHS.