重度阻塞性睡眠呼吸暂停综合征睡眠监测中窦性心率递增不良的临床分析及意义  

Clinical analysis on unsatisfactory progressive increase in sinus heart rate during sleep monitoring for severe sleep apnea syndrome

作　　者：王昊[1] 张希龙[1] 胡玲[1] 殷凯生[1] 李翀[1] 蔡毓英[2] 

机构地区：[1]南京医科大学第一附属医院呼吸科,江苏南京210029 [2]南京医科大学生理教研室,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2006年第7期585-588,F0002,共5页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:研究重度阻塞性睡眠呼吸暂停综合征(OSAS)患者窦性心率递增不良的临床意义。方法:按自行拟定的标准在重度OSAS者中筛选出窦性心率递增不良者在超微心电图仪的监测下进行阿托品试验。结果:发现窦性心率递增不良12例,2例拒绝进一步检查,1例以往已确诊为窦房结功能障碍且为房颤伴2度房室传导阻滞,其余9例进行了阿托品试验。结果:超微心电图(UMECG)监测结果均为阳性,诊断为窦房结功能障碍。而同步记录的心电图诊断则有4例阴性,含1例已临床确诊为窦房结功能障碍,2例临床不能完全排除窦房结功能障碍可能,1例无法临床判断。结论:重度OSAS患者窦性心率递增不良可能为窦房结功能障碍表现之一,UMECG有利于其中不典型病例的诊断。Objective： To investigate the clinical significance of unsatisfactory progressive increase in sinus heart rate during sleep monitoring for severe sleep apnea events in patients with severe obstructive sleep apnea syndrome （OSAS）. Methods：With the use of polysomnography,9severe OSAS patients with a maximal noctumalk sinus heart rate lower than 90 bpm during obstructive sleep apnea events were recruited.Atropine test monitored by ultra-micro-electocardiograph （UMECG） and ECG simultaneously was performed on these patients. Results： A positive result of atropine test was detected in all 9 patients monitored by UMECG and in 5 patients monitored by ordinary ECG. Conclusion： Unsatisfactory progressive increase in nocturnal sinus heart rate,as a predictor of sinus dysfunction,is common in patients with severe OSAS.UMECG recording may be more sensitive to identify such a sinus dysfunction.

关 键 词：阻塞性睡眠呼吸暂停综合征 窦性心率递增不良 窦房结功能 阿托品试验 超微心电图 

分 类 号：R563.8[医药卫生—呼吸系统]