老年冠心病与睡眠呼吸障碍的临床研究  

Clinical analysis of coronary artery disease in elderly patients with sleep disordered breathing

作　　者：刘惠霞[1] 靳朴[1] 钟志安[1] 卓胜青[1] 田相亭[1] 欧琼[1] 岑瑞金[1] 

机构地区：[1]广东省人民医院省老年医学研究所,广东广州510080

出　　处：《南方医科大学学报》2008年第7期1281-1283,共3页Journal of Southern Medical University

摘　　要：目的了解老年冠心病患者中睡眠呼吸障碍发生的情况及初步探讨两者的关系。方法经冠脉造影确认的老年冠心病患者62例及排除冠心病患者18例,全部接受夜间7h多导睡眠监护仪监测及同位素心室造影了解左心功能。结果62例老年冠心病患者有53.2%合并有睡眠呼吸障碍,非冠心病患者18例有22.2%合并有睡眠呼吸障碍,老年冠心病合并睡眠呼吸障碍的发生率明显高于非冠心病患者。冠心病合并睡眠呼吸障碍组与单纯冠心病组比较,夜间血氧饱和度较低,夜间血氧饱和度低于90%的时间较长,体重指数高,且有较高的高血压病发生率(P<0.05)。冠脉病变严重程度与呼吸絮乱指数无明显相关(r=-0.67,P>0.05)。结论老年冠心病患者合并睡眠呼吸障碍的发生率高,应重视老年冠心病患者夜间睡眠呼吸监测,对冠心病合并严重睡眠呼吸障碍者给予联合治疗。Objective To understand the prevalence of sleep disordered breathing （SDB） in elderly patients with coronary artery disease （CAD） and explore the relations between SDB and CAD. Methods Sixty-two elderly patients with and 18 without CAD identified by coronary angiography underwent examinations by polysomnography （PSG）. Left ventricular ejection fraction （LVEF） was measured by 99Tc equilibrium radionuclide angiography. Results In the 62 elderly patients with CAD, 53.2% had SDB, a rate significantly higher that （22.2%） in the 18 non-CAD patients. The CAD patients with SDB had higher respiratory disturbance index （RDI） and body mass index （BMI） and lower arterial saturation of oxygen （SaO2） during sleep, with longer duration of low SPO2 （less that 90%）. The incidence of hypertension was higher in CAD patients with SDB than in those without SDB. No significant correlation was found between the severity of coronary artery disease and RDI （r=-0.16, P〉0.05）. Conclusion The elderly patients with CAD have higher incidence of SDB, and appropriate interventions should be administered in those with severe SDB.

关 键 词：冠心病 睡眠呼吸暂停综合狂 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]