CPAP对重度OSA患者无创心电参数的影响

The effects of continuous positive airway pressure on QT dispersion,heart rate variability and ventricular late potential in patients with severe obstructive sleep apnea

目的 探讨持续气道正压通气(CPAP)对重度阻塞性睡眠呼吸暂停(OSA)患者QT离散度、心率变异性及心室晚电位的影响。方法 收集两家医院诊断重度OSA患者182例,其中CPAP治疗组102例,拒绝CPAP治疗组80例;在接受CPAP治疗前以及CPAP治疗3个月后,所有对象均进行QT离散度(QTd)、心率变异性(HRV)及心室晚电位(VLP)的检测,统计分析比较两组间以及CPAP治疗组治疗前后的临床及心电资料数据。结果 CPAP治疗组与对照组比较,QTd较对照组缩短、HRV较对照组减小、VLP阳性比例较对照组明显减少,差别具有统计学意义,p<0.05;在CPAP治疗组中,治疗前及治疗后3个月比较,CPAP治疗组3个月后的QTd较治疗前缩短、HRV较治疗前减小、VLP阳性比例较治疗前明显减少,差别具有统计学意义,p<0.05。结论 规范的CPAP治疗能有效改善重度OSA患者QTd、HRV、VLP,减少心律失常的发生及恶化。

Objective To investigate the effects of CPAP on QT dispersion, heart rate variability and ventricular late potential in patients with severe OSA. Methods A total of 182 patients with severe OSA diagnosed in two hospitals were collected, including 102 in the CPAP treatment group and 80 in the refusal group. Before and 3 months after CPAP treatment, all subjects were measured for QT dispersion(QTD), heart rate variability(HRV) and ventricular late potential(VLP). Clinical and ECG data between the two groups as well as before and after CPAP treatment were statistically analyzed and compared. Results Compared with the control group, QTD, HRV and VLP positive ratio of the CPAP treatment group were shortened, decreased, and the difference was statistically significant(p<0.05). In the CPAP treatment group, QTD, HRV and VLP positive ratio in the CPAP treatment group were shortened, decreased, and decreased significantly in the CPAP treatment group 3 months after treatment compared with before treatment, with statistical differences(p<0.05). Conclusions Standard CPAP treatment can effectively improve QTD, HRV, VLP, and reduce the occurrence and deterioration of arrhythmia in patients with severe OSA.