老年心血管病患者睡眠呼吸障碍和周期性腿动的研究  

Study of sleep-dyspnea and periodic leg movements in aged patients with cardiovascular diseases

作　　者：侯晓平[1] 缪京莉[1] 王玉军[1] 尹巧香[1] 杨军[2] 张宏金[2] 

机构地区：[1]中国人民解放军空军总医院干部病房,北京市100142 [2]空军航空医学研究所,北京市100142

出　　处：《实用老年医学》2010年第3期209-212,共4页Practical Geriatrics

摘　　要：目的探讨老年心血管病患者睡眠呼吸障碍和周期性腿动的患病情况和关系。方法采用RS-611床垫式睡眠呼吸监测系统在低生理负荷状态下对老年心血管病患者监测睡眠呼吸和肢体活动并分析。结果 (1)31例平均年龄(76.4±7.2)岁,检出阻塞性睡眠呼吸暂停综合征(OSAHS)26例,夜间低氧血症27例,睡眠期周期性腿动(PLMS)12例。(2)男性呼吸暂停指数明显高于女性(14.1±9.1和7.2±3.5,P<0.01);≥80岁组低通气指数(HI)明显高于<80岁组(9.8±10.6和2.6±1.7,P<0.01);夜间最低血氧饱和度(LO2)、平均血氧饱和度(AO2)明显低于<80岁组[(76.4±8.3)%和(81.9±5.9)%、(92.6±2.2)%和(94.0±1.1)%,均P<0.05]。(3)患者年龄与HI呈正相关(r=0.392,P<0.05),HI与LO2、AO2呈负相关(r=-0.410,-0.644,P<0.05或P<0.01)。(4)PLMS组冠脉严重病变患者明显多于非PLMS组,超声左室射血分数、短轴缩短率明显低于对照组(均P<0.05)。结论老年心血管病患者OSAHS患病率高,程度随增龄加重,睡眠呼吸障碍以低通气为著。PLMS者多合并更为严重的冠脉病变和左室收缩功能减低。Objective To investigate the prevalence of sleep-dyspnea and periodic leg movements in sleep （PLMS） in aged patients with cardiovascular diseases （CVD）. Methods The data of 31 patients averaged 76.4±7.2 years with CVD monitored by RS-611 mattress monitoring system of sleep were analysed. Results Twenty-six cases of obstructive sleep apnea-hypopnea syndrome （OSAHS） and 12 cases of PLMS were detected. The apnea index（AI）of the males was significantly higher than that of the females （14.1±9.1 vs 7.2±3.5,P〈0.01）. Compared with patients aged under 80 years,hypopnea index（HI）was significantly higher and lowest oxygen saturation（LO2）,average saturation of blood oxygen （AO2） were significantly lower in patients aged over 80 years [HI 9.8±10.6 vs 2.6±1.7,P〈0.01; LO2 （76.4±8.3）% vs （81.9±5.9）%,AO2 （92.6±2.2）% vs （94.0±1.1）%,P〈0.05 respectively]. HI was positively correlated with age of patients（r=0.392,P〈0.05）and negatively correlated with LO2 and AO2（r=-0.410,-0.644;P〈0.05 or P〈0.01,respectively）. The patients with PLMS had significantly lower left ventricular ejection fraction and lower rate of fraction shortening measured by echocardiogram（0.542±0.030 vs 0.574±0.040,0.258±0.021 vs 0.280±0.029,P〈0.05,respectively）and more cases with serious coronary artery lesion than those without PLMS. There was no difference in parameters of sleep-dyspnea between the two groups. Conclutions The prevalence of OSAHS in aged patients with CVD is high and increases with age. Hypopnea and hypoxemia are predominant features. The patients with PLMS are complicated with even more serious coronary artery disease and degrade of left ventricular function.

关 键 词：睡眠呼吸暂停综合征 心血管疾病 周期性腿动 老年人 

分 类 号：R54[医药卫生—心血管疾病]