急性心肌梗死患者长期睡眠质量与冠状动脉病变严重程度的相关性研究

Correlation between long-term sleep quality and severity of coronary artery disease in patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者长期睡眠质量与冠状动脉(冠脉)病变严重程度的相关性。方法:纳入2023年1月—2024年1月就诊于河北中石油中心医院急诊科、廊坊市人民医院急诊科并确诊为AMI的患者,根据造影检查结果分为单支病变组,双支病变组、3支病变组。收集患者一般临床资料及实验室数据,行匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)问卷调查。结果:①单支病变、双支病变、3支病变组之间,高血压、糖尿病、吸烟史、低密度脂蛋白、Gensini评分、PSQI积分差异有统计学意义(P<0.05)。②Spearman相关性分析提示PSQI积分与Gensini评分呈正相关(rs=0.722,P<0.001)。③以Gensini评分≥20为因变量,应用二分类logistic回归分析冠脉严重程度的危险因素,结果提示糖尿病、吸烟史、低密度脂蛋白、PSQI积分为冠脉病变严重程度的危险因素(P<0.05)。④ROC曲线分析提示PSQI积分对冠脉病变严重程度有预测价值(AUC=0.832,P<0.001)。结论:在AMI患者中,长期睡眠质量差是冠脉病变严重程度的独立危险因素。

Objective To investigate the correlation between long-term sleep quality and the severity of coronary artery lesions in patients with acute myocardial infarction(AMI).Methods Patients diagnosed with AMI in the emergency Department of Hebei petrochina Central Hospital and Langfang People's Hospital from January 2023 to January 2024 were included,and were divided into single-vessel lesion group,double-vessel lesion group and 3-vessel lesion group according to angiographic examination results.General clinical data and laboratory data were collected,and pittsburgh sleep quality index(PSQI)questionnaire was conducted.Results①There were significant differences in hypertension,diabetes,smoking history,low density lipoprotein,Gensini score and PSQI score among the three groups(P<0.05).Spearman correlation analysis showed that PSQI score was positively correlated with Gensini score(rs=0.722,P<0.001).③With Gensini≥20 as the dependent variable,binary logistic regression was used to analyze the risk factors of coronary severity,and the results indicated that diabetes,smoking history,low density lipoprotein and PSQI score were the risk factors of coronary severity(P<0.05).(4)ROC curve analysis indicated that PSQI score had predictive value in the severity of coronary lesions(AUC=0.832,P<0.001).Conclusion In AMI patients,long-term poor sleep quality is an independent risk factor for the severity of coronary artery disease.