睡眠呼吸暂停综合征与心脑血管疾病的相关性研究

Correlation between sleep apnea syndrome and cardiovascular diseases

目的:探讨不同程度睡眠呼吸暂停综合征(sleepingapneasyndrome,SAS)患者心脑血管病发生率及其两者的相关性。方法:63例疑似患有SAS患者,依据多导睡眠图(polyguidancesleepinggraphy,PSG)监测结果,分为正常、轻度、中度、重度睡眠呼吸暂停4组,根据临床表现、血液生化指标、心电图、心脏超声、动态血压及冠状动脉脉照影、颅脑CT等检查诊断心脑血管疾病,分析不同程度睡眠呼吸暂停患者心脑血管疾病发生率。结果:体质量指数(bodymassindex,BMI)与呼吸暂停指数(apnea-hypoventilationindex,AHI)、呼吸紊乱指数(respiratorydisorderin-dex,RDI)、氧减饱和度指数显著正相关(r=0.355,0.373,0.375,P<0.05);中、重度SAS组心血管病发生(心肌缺血:7/16,15/21;心绞痛:5/16,11/21;心肌梗死:4/16,10/21)明显高于正常(3/11,2/11,2/11)及轻度SAS组(5/15,3/15,3/15)(P<0.05或0.01);轻、中、重度SAS组脑卒中的发生率均显著高于正常组(P<0.05);4组患者高血脂与糖尿病发生率差异无显著意义(P>0.05)。结论:睡眠呼吸暂停的程度与心血管疾病的发生呈正相关。

AIM:To explore the incidence of cardiovascular diseases in patients with sleep apnea syndrome(SAS), and to investigate the correlation between severity of sleep apnea and incidence of cardiovascular diseases in order to cardiovascular disease and sleep apnea. METHODS: Sixty three patients suspected with SAS were divided into normal,mild,moderate, and severe sleep apnea groups according to the monitoring result of polyguidance sleeping graph(PSG). The diagnosis of cardiovascular diseases was made according to clinical symptom,blood biochemical indices, electrocardiogram (ECG), ultracardiogram(UCG), dynamic blood pressure and coronary angiography. The incidence of cardiovascular diseases in patients with SAS of different levels was analyzed. RESULTS:Body mass index(BMI) was significantly and positively related to apnea hypoventilation index(AHI), respiratory disorder index(RDI) and oxygen saturation reduction index(r=0.355,0.373,0.375,P< 0.05). The incidences of cardiovascular diseases in the moderate and severe SAS groups(myocardial ischemia: 7/16, 15/21; angina: 5/16, 11/21; myocardial infarction: 4/16, 10/21) were significantly higher than that in the normal(3/11, 2/11, 2/11) and mild( 5/15, 3/15, 3/15) SAS group(P< 0.05,P< 0.01). The incidences of stroke in the mild, moderate, and severe SAS groups were significantly higher than that in the normal group(P< 0.05). There were no significant differences in the incidence of hyperlipidemia and diabetes among the four groups (P >0.05). CONCLUSION: The level of sleep apnea syndrome is positively related to the incidence of cardiovascular disease.