冠心病患者合并中、重度OSAS的影响因素及其对PCI术后预后的影响

An analysis of influencing factors for coronary heart disease patients complicated with moderate and severe OSAS and its innuence on prognosis after PCI

目的探讨冠心病患者合并中、重度阻塞性睡眠呼吸暂停综合征(OSAS)的影响因素及其对经皮冠状动脉介入治疗(PCI)术后预后的影响。方法行PCI的冠心病患者340例,根据睡眠呼吸暂停低通气指数(AHI)分为A组(中、重度OSAS,AHI≥15次/小时,152例)和B组(无OSAS和轻度OSAS,AHI<15次/小时,188例)。采用多因素logistic回归分析冠心病患者合并中、重度OSAS的独立危险因素。随访24个月,记录主要不良心血管事件(MACE)发生情况,Kaplan-Meier法绘制累积MACE发生曲线。结果与B组比较,A组男性、高血压和冠状动脉多支病变的比例以及BMI、颈围、腹围、hsCRP、IL-6、AHI、氧减饱和度指数较高,基线SpO_(2)、最低SpO_(2)和LVEF较低(P<0.05)。男性、冠状动脉多支病变以及BMI、hsCRP、IL-6较高是冠心病患者合并中、重度OSAS的独立危险因素,LVEF较高是其独立保护性因素(P<0.05)。A组患者累积MACE发生率高于B组(P<0.05)。结论性别、冠状动脉病变支数、BMI、hsCRP、IL-6、LVEF是影响冠心病患者合并中、重度OSAS的独立因素,合并中、重度OSAS的冠心病患者PCI术后预后更差。

Objective To analyze the influencing factors for coronary heart disease patients complicated with moderate and severe obstructive sleep apnea syndrome(OSAS)and its influence on prognosis after percutaneous coronary intervention(PCI).Methods A total of 340 patients with coronary heart disease undergoing PCI were divided into two groups of A(moderate and severe OSAS,AHI≥15 times per hour,152 cases)and B(without OSAS and mild OSAS,AHI<15 times per hour,188 cases).The independent risk factors for the patients with coronary heart disease complicated with moderate and severe OSAS were analyzed by multivariate logistic regression analysis.The major adverse cardiovascular events(MACE)were recorded after 24-month follow-up.Kaplan-Meier method was used to draw the cumulative MACE incidence curve.Results Compared with group B,group A had higher proportion of male,hypertension and coronary multi-vessel diseases,BMI,neck circumference,abdominal circumference,hsCRP,IL-6,AHI and ODI,and lower baseline SpO_(2),minimum SpO_(2) and LVEF(P<0.05).The male,multi-vessel diseases,and higher BMI,hsCRP and IL-6 were the independent risk factors for coronary heart disease patients complicated with moderate and severe OSAS,and higher LVEF was a independent protective factor(P<0.05).The cumulative incidence of MACE in group A was higher than that in group B(P<0.05).Conclusion Gender,number of lesions,BMI,hsCRP,IL-6 and LVEF are the independent influencing factors for the patients with coronary heart disease complicated with moderate and severe OSAS.The patients with coronary heart diseases complicated with moderate and severe OSAS have worse prognosis after PCI.