影响阻塞性睡眠暂停综合征患者左心室结构改变主要原因的探讨  

Systolic blood pressure and body mass index are the mainly possible contributors to the alteration of left ventricular structure in patients with obstructive sleep apnea syndrome

作　　者：杨晶晶[1,2] 严志涛[2] 姚晓光[2] 宋海峰[2] 汪迎春[2] 王红梅[2] 李南方[2] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]新疆维吾尔自治区人民医院高血压科新疆高血压研究所

出　　处：《临床心血管病杂志》2010年第7期510-513,共4页Journal of Clinical Cardiology

基　　金：新疆高血压病研究实验室开放课题资助(No:XJYS0906)

摘　　要：目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者左心室结构改变的可能影响因素。方法:随机抽取2004-2007年就诊新疆自治区人民医院高血压中心住院及门诊患者449例,行夜间多导睡眠监测及心脏彩超检查。根据睡眠呼吸暂停低通气指数(AHI)≥10次/h,将患者分为OSAS组(300例)及非OSAS组(149例),分别比较左心室结构指标的变化,并探讨OSAS患者左心室结构改变的影响因素。结果:①OSAS组左心室肥厚(LVH)的患病率明显高于非OSAS组(15.3%:7.4%,P=0.017),OSAS患者室间隔厚度(IVSd)及左心室后壁厚度(LVPWd)均明显高于非OSAS人群,差异有统计学意义(P<0.05),而校正颈围、腹围、血压及体质指数(BMI)的影响后发现,IVSd及LVPWd在2组间差异无统计学意义;②简单Pearson相关分析显示:IVSd、LVP-Wd与颈围、腹围、BMI、AHI、收缩压、舒张压正相关,而与性别、最低血氧饱和度呈负相关;LVPWd与年龄及HDL呈负相关。而进一步做多重线性回归分析显示:仅收缩压、性别及BMI与IVSd、LVPWd相关。结论:OS-AS患者左心室结构改变较非OSAS患者明显,可能主要是受到SBP、性别及BMI的影响。Objective：To explore the possible contributing factors to the left ventricular structure alteration in patients with obstructive sleep apnea syndrome （OSAS）.Method：The total of 449 outpatients and inpatients who attended the Hypertension Center from 2004 to 2007 were selected randomly.All subjects underwent polysomnography and echocardiography.The related index of left ventricular structure were compared between 300 individualswith OSAS and 149 cases without OSAS Age,Body mass index （BMI）,Blood pressure,and prevalence of hypertension were matched.Result：①The prevalence of left ventricular hypertrophy （LVH） was significantly higher in patients with OSAS compared with those without OSAS （15.3%：7.4%,P=0.017）,so are the interventricular septum thickness in diastole （IVSd） and the left ventricular posterior wall thickness in diastole （LVPWd）.However,there was no statistical significance between two groups when several correlated factors had been adjusted,such as Neck collar,Abdomen circumference,BMI and Diastolic blood pressure （DBP）.②Pearson correlation analysis indicated that IVSd,LVPWd correlated positively with Neck collar,Abdomen circumference,BMI,apnea hypoventilation index,Systolic blood pressure （SBP） and DBP,and negatively with gender,LSaO2.In addition,age and high density lipoprotein also had negative correlation with LVPWd.The multiple linear regression model subsequently showed that IVSd,LVPWd just related to SBP,gender and BMI.Conclusion：The changes of left ventricular structure are greater in patients with OSAS,which may primarily attribute to SBP,gender and BMI.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 室间隔厚度 左心室后壁厚度 收缩压 体质指数 

分 类 号：R563.8[医药卫生—呼吸系统]