OSAHS对心力衰竭患者心功能、心率变异性及预后的影响

Influence of obstructive sleep apnea hypopnea syndrome on heart function,heart rate variability and prognosis in patients with heart failure

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对心力衰竭(心衰)患者心功能、心率变异性及预后的影响。方法选择2021年3月至2024年3月于青岛市市立医院收治的140例急性心衰患者进行研究,根据患者是否合并OSAHS分为OSAHS组(n=59)和非OSAHS组(n=81)。比较两组患者睡眠呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(SaO_(2))、左室射血分数(LVEF)、脑钠肽(BNP)、全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值的标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)、相邻NN间期之差>50 ms的个数所占总窦性心博个数的百分比(PNN50),并比较其预后情况。结果OSAHS组AHI、BNP均高于非OSAHS组,夜间最低SaO_(2)、LVEF均低于非OSAHS组,差异有统计学意义(P<0.05);OSAHS组SDNN、SDANN、RMSSD、PNN50均低于非OSAHS组(P<0.05);随访显示,OSAHS组不良心血管事件发生率高于非OSAHS组,差异有统计学意义(P<0.05)。结论OSAHS可影响心衰患者的心功能、心率变异性、短期预后,临床应予以关注。

Objective To investigate the influence of obstructive sleep apnea hypopnea syndrome(OSAHS)on heart function,heart rate variability(HRV)and prognosis in patients with heart failure(HF).Methods The patients with acute HF(n=140)were chosen from Municipal Hospital of Qingdao City from Mar.2021 to Mar.2024.All patients were divided into OSAHS group(n=59)and non-OSAHS group(n=81).The data of sleep apnea hypopnea index(AHI),nighttime minimum blood oxygen saturation(SaO_(2)),left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),standard deviation of RR intervals for the total sinus beats(SDNN),standard deviation of average RR intervals(SDANN),root mean square of differences between adjacent RR intervals(RMSSD),percentage of number of adjacent NN intervals differing more than 50 ms in the total number of sinus beats(PNN50)and prognosis were compared between 2 groups.Results The levels of AHI and BNP were higher,and nighttime minimum SaO_(2)and LVEF were lower in OSAHS group than those in non-OSAHS group(P<0.05).SDNN,SDANN,RMSSD and PNN50 were lower in OSAHS group than those in non-OSAHS group(P<0.05).The results of follow-up showed that incidence rates of adverse cardiovascular events were higher in OSAHS group than those in non-OSAHS group(P<0.05).Conclusion OSAHS can affect heart function,HRV and shot-term prognosis in HF patients,which should be paid attention to in clinical practice.