老年人阻塞型睡眠呼吸暂停低通气综合征与心律失常的临床观察  

Study on correlation between obstructive sleep apnea hypopnea syndrome and arrhythmia in the elderly

作　　者：赵兴胜[1] 斯琴高娃[1] 王红雨[1] 刘喜[1] 闫丽梅[1] 李继平[1] 

机构地区：[1]内蒙古自治区医院心内科,呼和浩特市010017

出　　处：《中华老年医学杂志》2007年第5期348-350,共3页Chinese Journal of Geriatrics

基　　金：中央保健委员会专项资金科研课题（2002蒙A042）

摘　　要：目的探讨老年人阻塞型睡眠呼吸暂停低通气综合征（OSAHS）与心律失常的关系。方法选择116例打鼾患者根据多导睡眠图（PSG）监测结果和年龄分为老年鼾症组、老年OSAHS组和非老年OSAHS组,部分老年中重度OSAHS患者经鼻持续气道正压（n-CPAP）治疗;并同步动态心电图监测,比较各组心律失常发生情况。结果老年OSAHS组心律失常发生率显著高于老年鼾症组和非老年OSAHS组（71．8%对48%和53．3%,P＜0．01）。与老年鼾症组比较,窦性心动过速、短阵心房颤动多见;与非老年OSAHS组比较,窦性心动过缓、窦性停搏、房室阻滞和房性心律失常多见。老年OSAHS组高血压、冠心病患病率显著高于老年鼾症组和非老年OSAHS组（69．6%对28%和40%;56．5%对32%和24．4%;P＜0．01）;经n-CPAP治疗后老年OSAHS组心律失常发生率显著降低（77．3%和45．4%,P＜0．05）。结论老年OSAHS患者心律失常发生率高可能与睡眠时反复发作低氧血症、易患心血管疾病有关。Objective To investigate the relationship between obstructive sleep apnea syndrome （OSAHS） and arrhythmia in the elderly. Methods One hundred and sixteen snored patients were selected and divided into three groups according to the age and the result of polysomnography （PSG）： snored group （≥60 years）, old OSHAS group （≥60 years）and young OSAHS group（〈60 years）. Some patients in OSHAS group were treated with nasal continuous positive airway pressure （n-CPAP） and monitored with dynamic electrocardiogram （DCG）. Results The incidence of arrhythmia in old OSHAS group was significantly higher than that in snored group and young OSAHS group（71.8%, 48% and 53.3%, all P〈0.01）. The sinus tachycardia and short term atrial fibrillation in OSAHS group occurred more often than in snored group, and sinus bradycardia , sinus pause, atrioventricular block and atrial arrhythmia occurred more often in old OSAHS group than in young OSAHS group. The prevelances of hypertension and coronary atherosclerotic heart disease in old OSAHS group were higher than in snored group and in young OSAHS group[（69.6% , 28% ）vs（40% , 56.5%） vs （32% and 24.4%）,P〈0.01）.The occurrence of arrhythmia in elderly OSAHS group decreased significantly after the treatment of n CPAP（ 77.3% and 45.4%, P〈0.05）. Conclusions The occurrence of cardiac arrhythmia in elderly OSAHS patients is probably related to recurrent nocturnal hypoximea during sleep.

关 键 词：阻塞性睡眠呼吸暂停 心律失常 

分 类 号：R686[医药卫生—骨科学]