老年慢性充血性心力衰竭与睡眠呼吸障碍的关系  

Relationship between chronic congestive heart failure and sleep-disordered breathing in elderly patients

作　　者：刘惠霞[1] 黄平[1] 陈勇驰[1] 卓胜青[1] 钟志安[1] 杨辉剑[1] 欧琼[1] 岑瑞金[1] 

机构地区：[1]广东省人民医院老年医学研究所,广东广州510080

出　　处：《南方医科大学学报》2006年第6期847-848,共2页Journal of Southern Medical University

摘　　要：目的了解老年慢性充血性心力衰竭(心衰)患者睡眠呼吸障碍的发生情况,并探讨不同程度睡眠呼吸障碍与左心功能的关系。方法入选56例老年慢性心衰患者,行多导睡眠图(PSG)检测,根据PSG检测结果,将老年慢性心衰患者分为正常、轻度、中度、重度睡眠呼吸障碍4组,用平衡法放射核素心室造影测定左心室射血分数(LVEF)。结果老年慢性心衰患者睡眠呼吸暂停综合征(SAS)的发生率为67.9%,其中心衰合并轻度、中度、重度SAS的发生率分别为21.4%、25.0%和21.4%,SAS发生的类型以阻塞性睡眠呼吸暂停多见,发生率为53.6%,中枢性睡眠呼吸暂停占7.1%,混和性睡眠呼吸暂停占39.3%。心衰合并中度、重度睡眠呼吸障碍组与单纯心衰组相比,LVEF较低,夜间平均血氧饱和度较低。睡眠呼吸暂停/低通气指数与LVEF呈负相关(r=-0.74,P<0.01)。结论老年慢性充血性心衰患者睡眠呼吸障碍的发生率高,严重睡眠呼吸障碍可能影响左心功能,应重视老年慢性心衰患者睡眠呼吸障碍的诊治。Objective To determine the prevalence of sleep disordered breathing （SDB） in elderly patients with chronic congestive heart failure （CHF） and explore the relations between SDB and left ventricular function. Methods By means of polysomnography, 56 elderly patients with CHF were divided into non-SDB, mild SDB, moderate SDB, and severe SDB groups, and the left ventricular ejection fraction （LVEF） was measure by 99Tc equilibrium radionuclide angiography. Results In the 56 elderly patients with CHF, 38 （67.9%） had SDB, including 12 （21.4%） mild SDB, 14 （25.0%） moderate SDB, and 12 （21.4%） severe SDB patients. Thirty （53.6%） of the 56 patients with CHF had obstructive sleep apnea （OSA）, 4 （7.1%） had central sleep apnea and 22 （39.2%） had mixed sleep apnea. The moderate and severe SDB groups had lower minimum arterial oxyhemoglobin saturation during sleep than the non-SDB groups, and the apnea-hyponea index was closely related to LVEF （γ=-0.74, P〈0.01）. Conclusions The prevalence of SDB, predominantly OSA, is high in elderly patients with CHF. Moderate and severe SDB might affect the left ventricular function in these patients, who require polysomnography monitoring.

关 键 词：心力衰竭 充血性 睡眠呼吸暂停综合征 老年人 

分 类 号：R541.61[医药卫生—心血管疾病]