手术治疗对阻塞性睡眠呼吸暂停低通气综合征患者夜间微觉醒与心率变异的影响  

Peri-uvulopalatopharyngoplasty changes on the relationship between arousal and nocturnal heart rate variability in patients with OSAHS

作　　者：姚行齐[1] 杨慧[1] 杨长亮[1] 褚勇[1] 

机构地区：[1]广州军区武汉总医院耳鼻咽喉科,武汉430070

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第24期1122-1123,1126,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者微觉醒与心率变异(HRV)的关系及手术后的变化。方法:对54例重度OSAHS患者行手术前后PSG。分析1 h内每个呼吸紊乱相关微觉醒开始前10 s的平均心率(HR)和微觉醒开始后10 s的最高HR比较。同时计算1 h内呼吸紊乱相关微觉醒指数(B-Arl)和脉率升高指数(PRRI)并作相关分析。比较不伴微觉醒事件和伴有微觉醒事件的心率差(△HR)及手术后的影响。结果:微觉醒开始后10 s的最高HR显著高于微觉醒开始前的平均HR,且B-Arl与PRRI呈显著正相关,伴有微觉醒的呼吸事件终止前后△HR显著高于不伴微觉醒的呼吸事件的△HR,手术后患者△HR显著低于术前。结论:B-Arl与夜间HRV相关,提示微觉醒可影响心血管调节功能,频繁的微觉醒是导致心血管疾病的重要原因之一。手术可通过减少微觉醒来减轻患者的心血管损害。Objective： To study the relationship between arousal and nocturnal apnea-hypopnea syndrome （OSAHS）. Method：Fifty four patients with OSAHS underwent overnight polysomnoyraphy（PSG） were enrolled, An hour continuous PSG monitoring in non-rapid eye movement（NREM） was recorded for all patients. The mean heart rate （HR） in 10s before each arousal and the peak HR IN 10s after arousal were compared, and the breathing disorder related arousal index （B-ArL） and pulse rate rise index （PRRI） were calculated at this time, and then a correlation analysis were performed and then △HR at apnea termination between these eveuts were compared. Result： the peak HR in 10s after arousal onset was significantly higher than the mean HR in 10s before arousal onset, and B-Arl was positively correlated to PRRI. the △HR of events with EEG arousal at apnea terimination was higher than those without EEG arousal. Conclusion：The results indicate that arousal can influence the function of cardiovascular regulation. Frequent arousal is one of the main causes of the cardiovascular consequences in OSAHS patiens. Operation can reduce these influences.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 多道睡眠描记术 微觉醒 心率变异 

分 类 号：R563.8[医药卫生—呼吸系统]