阻塞性睡眠呼吸暂停对左心室结构及整体功能影响的研究  

The impact of obstructive sleep apnea on left ventricular structure and global function

作　　者：艾力根.阿不都热依木 阿孜古丽.买合买提 尤乐都斯[1] 阿不都如苏力[1] 海力比努尔[3] 程秀琴[1] 顾兴智[1] 

机构地区：[1]新疆维吾尔自治区人民医院耳鼻咽喉科,乌鲁木齐830001 [2]新疆石油管理局乌鲁木齐明园石油医院内科 [3]新疆维吾尔自治区人民医院超声科,乌鲁木齐830001

出　　处：《中华临床医师杂志（电子版）》2011年第14期4022-4028,共7页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨阻塞性睡眠呼吸暂停(OSA)对左心室结构及整体功能的影响。方法横断面研究设计,对82例经整夜多导睡眠监测确诊为阻塞性睡眠呼吸暂停综合征(OSAS)且其他方面正常的患者进行超声心动图检测获取反映左心室结构及功能的超声学参数,并计算左心室心肌重量指数(LVMI)及Tei指数。根据呼吸暂停低通气指数(AHI)将患者分为三组:轻度OSAS(AHI 5~20次/h);中度OSAS(AHI 21~40次/h);重度OSAS(AHI>40次/h),比较各组患者的超声学参数。结果三组患者年龄、体重指数、性别构成比较无统计学差异。中、重度OSAS患者舒张末期室间隔厚度(IVSd)分别为:(10.0±1.1)mm、(10.9±1.0)mm;舒张末期左心室后壁厚度(LVPWd)分别为:(10.1±0.9)mm、(11.4±0.9)mm;左心室心肌重量(LVM)分别为:(261.0±47.3)g、(274.0±49.6)g;左心室心肌重量指数(LVMI)分别为:(124.2±24.8)g/m2、(127.8±18.1)g/m2,与轻度OSAS患者[LVPWd(9.7±0.8)mm;IVSd(9.3±0.9)mm;LVM(21...Objective To explore the effect of obstructive sleep apnea on left ventricular morphology and global function.Methods A cross-sectional study,82 otherwise health patients with obstructive sleep apnea syndrome which confirmed by overnight polysomnography were included and obtained echocardiographic parameters that reflective left ventricular structure and function from echocardiographic measurements and calculated left ventricular mass index(LVMI) and myocardial performance index(MPI).According to apnea-hypopnea index(AHI),subjects were classified into three groups: mild OSAS(5<AHI≤20);moderate OSAS(21<AHI≤40) and severe OSAS(AHI>40),and echocardiographic parameters were compared wmong the three groups.Results There were no significant differences in age,body mass index and sex among the groups.In moderate and severe OSAS patients,IVSd were(10.0±1.1)mm and(10.9±1.0)mm and LVPWd were(10.1±0.9)mm and(11.4±0.9)mm,respectively,LVM were(261.0±47.3)g and(274.0±49.6)g and LVMI were(124.2±24.8)g/m2 and(127.8±18.1)g/m2,respectively.Those were significantly higher than mild OSAS patients [LVPWd:(9.7±0.8)mm;IVSd:(9.3±0.9)mm;LVM:(218.4±38.6)g;LVMI:(109.8±18.0)g/m2] and have statistically significant.There were no statistically significant in those echocardiographic parameters between moderate and severe OSAS patients groups.In the three OSAS patients groups,MPI were 0.39±0.05,0.47±0.07,0.53±0.11,respectively.In moderate and severe OSAS patients MPI were significantly higher than mild OSAS patients,but no statistically significant between moderate and severe OSAS patients.Regression analyses showed that there were positive correlation between MPI and AHI(standardized partial regression coefficient was 0.779,P=0.000).Conclusions Moderate and severe OSAS patients have higher LVMI and MPI,OSA is associated with impaired Left ventricular global function.

关 键 词：睡眠呼吸暂停 阻塞性 心室功能 左 左心室结构 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]