阻塞性睡眠呼吸暂停低通气综合征伴冠心病冠状动脉血管重构的初步研究

A preliminary study of coronary vascular remodeling in patients with obstructive sleep apnea-hypopnea syndrome and coronary heart disease

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)伴冠心病的左冠状动脉前降支血管重构特点。方法回顾性分析2014年2月~2019年10月我院收治的40例OSAHS伴冠心病患者临床资料,所有患者均行320排CT容积扫描冠状动脉CTA高分辨成像检查,依据重构指数将患者分为正性重构(positive remodeling,PR)组和非正性重构(negative remodeling,NR)组,比较组间血管及斑块量化指标和血管病变特点。结果PR组最狭窄处管壁面积、斑块面积、斑块最大厚度均高于NR组(P<0.05),斑块毛糙、稍低密度软斑在PR组所占比率明显高于NR组(P<0.05),但两组间狭窄率差异无统计学意义(P>0.05)。结论OSAHS伴冠心病患者左冠前降支正性重构者斑块特点,可能反映斑块风险,需要临床医师投入更多的关注。

Objective To investigate the characteristics of left anterior descending coronary artery remodeling in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)and coronary heart disease.Methods The clinical data of 40 patients with OSAHS and coronary heart disease(CHD)treated in our hospital from February 2014 to October 2019 were analyzed retrospectively.All patients underwent high resolution coronary CT angiography.According to the remodeling index,the patients were divided into positive remodeling(PR)and negative remodeling(NR)group.The quantitative indexes of blood vessels and plaques and the characteristics of vascular lesions were compared between the two groups.Results The area of the narrowest wall,the area of plaque and the maximum thickness of plaque in PR group were higher than those in NR group(P<0.05).The proportion of plaque roughness and slightly low density soft plaque in PR group was significantly higher than that in NR group(P<0.05),but there was no significant difference in stenosis rate between the two groups(P>0.05).Conclusion Plaque characteristics of positive remodeling of the left anterior descending branch in patients with OSAHS associated with coronary heart disease,which may indicate a higher risk,need more attention from clinicians.