冠心病伴阻塞性睡眠呼吸暂停低通气综合征患者的心电变化  

Change of cardiac electricity in patients with coronary heart disease complicated with obstructive sleep apnea hypopnea syndrome

作　　者：贺涛[1] 陈扬[1] 李刚[1] 陶建虹[1] 

机构地区：[1]四川省人民医院心内科,成都610072

出　　处：《临床心血管病杂志》2011年第9期674-676,共3页Journal of Clinical Cardiology

摘　　要：目的:研究冠心病(CHD)伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者与单纯CHD患者心电的变化。方法:选取行24h动态心电图检测的单纯CHD患者42例(Ⅰ组),CHD伴OSAHS患者47例(Ⅱ组),对比分析Ⅰ组和Ⅱ组发生心律失常情况及心率变异性时域、频域指标,对其中室性期前收缩患者比较其窦性心率震荡指标。结果:房性心律失常和室性心律失常发生率Ⅱ组均明显高于Ⅰ组;Ⅱ组心率变异性时域指标SDNN[(91.51±16.43)∶(128.12±13.78)ms,P<0.05],SDANNI[(83.44±16.21)∶(117.32±17.68)ms,P<0.05],SDNNI[(33.15±9.89)∶(48.17±11.69)ms,P<0.05],均显著低于Ⅰ组;2组窦性心率震荡指标TO、TS值差异均有统计学意义(P<0.05)。结论:CHD伴OSAHS患者心律失常发生率明显增高,心率变异性显著降低,窦性心率震荡减弱。Objective：To explore the change of cardiac electricity in coronary heart disease（CHD） patients complicated with obstructive sleep apnea hypopnea syndrome（OSAHS）. Method：The 24-hour Dynamic Electrocardiogram（DECG） was detected in group Ⅰ with 42 CHD patients and group Ⅱ with 47 CHD patients complicated with OSAHS.We analyzed the cardiac arrhythmia,the time domain and frequency domain of heart rate variability（HRV） and defined heart rate turbulence（HRT） index in patients with ventricular premature beats. Result：Group Ⅱ experienced significantly higher incidence rate of atrial arrhythmia and ventricular arrhythmia than group Ⅰ.HRV time domain index SDNN（[91.51±16.43] vs [128.12±13.78]ms,P0.05）,SDANN Index（[83.44±16.21] vs [117.32±17.68]ms,P0.05） and SDNN Index（[33.15±9.89] vs [48.17±11.69]ms,P0.05） were significantly lower than those of group Ⅰ.The difference of HRT index TO and TS values between groups Ⅰ and Ⅱ were distinct（P0.05）. Conclusion：Arrhythmia incidence in CHD patients complicated with OSAHS is significantly higher,with lower HRV and reduced HRT.

关 键 词：冠心病 阻塞性睡眠呼吸暂停低通气综合征 心律失常 心率变异性 窦性心率震荡 

分 类 号：R541.4[医药卫生—心血管疾病]