睡眠呼吸暂停综合征和冠心病的关系  

The relationship between coronary heart disease and sleep apnea syndrome

作　　者：罗勤[1] 柳志红[1] 赵智慧[1] 熊长明 倪新海[1] 马秀平[1] 杨跃进[1] 陈纪林[1] 戴军[1] 高润霖[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院肺血管病诊治中心,100037

出　　处：《中国分子心脏病学杂志》2007年第6期351-354,共4页Molecular Cardiology of China

摘　　要：目的睡眠呼吸暂停综合征与冠心病关系密切,但国内尚缺乏有关的流行病学资料,本研究旨在了解国人冠心病(coronary heart disease,CAD)合并睡眠呼吸暂停综合征(sleep apnea syn- drome,SAS)的发生率及其相关关系。方法对2004年10月至2005年3月以胸痛待查或冠心病收入我巾心拟行冠状动脉造影的所有221例患者进行睡眠呼吸监测,及抽血化验血脂、尿酸、C-反应蛋白等,对其结果进行分析。结果共204例患者加入研究,冠状动脉造影确诊CAD154例,其中单支病变38例,双支病变47例,三支病变54例,左主干病变15例;冠状动脉造影确诊CAD的患者合并SAS 86例,发生率为55.8%;非CAD组50例,合并SAS 22例,发生率为44.0%。CAD组SAS发生率明显高于非CAD组(P<0.05)。Logistic回归分析显示校正年龄、吸烟、高血压等因素后,睡眠呼吸暂停指数(AHI)≥20的患者合并CAD的危险是AHI<20患若的7.7倍(P=0.017)。结论CAD合并SAS的发生率高,SAS是CAD可能的危险因素,对CAD患者应进行睡眠呼吸监测,及早诊断将有利于冠心病的治疗。Objective Sleep apnea syndrome （SAS） is associated with coronary artery disease （CAD）. There was less epidemical data about it in China. The objective of this study is to investigate the prevalence of CAD with SAS. Methods In 204 consecutive inpatients angiography and sleep-breath monitor were performed from November 2004 to March 2005. Serum levels of TG,HDL,LDL ,URIC and CRP were investigated. Results 154 patients were diagnosed CAD and 50 patients were excluded CAD. The prevalence of SAS in patients with CAD was higher than those with no CAD, respectively 55.8% （86/154） VS 44.0% （22/50）. In multiple logistic regression model, the risk of CAD in patients with AHI ≥20 is 7.7 times than that in patients with AHI 〈 20 after emendating the risk factors such as age. hypertension and smoking （ OR 7.7, P = 0.017）. Conclusions There is high prevalence in patients with CAD and SAS, SAS is the possible risk of CAD. Sleep-breath monitor should be performed in patients with CAD.

关 键 词：冠心病 睡眠呼吸暂停综合征 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病] R766[医药卫生—内科学]