老年心血管病患者高尿酸血症与睡眠呼吸暂停低通气综合征的相关性研究  

Relationship between hyperuricemia and sleep apnea hypopnea syndrome in aged patients

作　　者：侯晓平[1] 张婧[1] 王玉军[1] 缪京莉[1] 陈艳芳[1] 马艳敏[1] 

机构地区：[1]空军总医院干部病房,北京100142

出　　处：《中国临床保健杂志》2015年第2期116-119,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨老年心血管病患者高尿酸血症(HUA)与睡眠呼吸暂停低通气综合征(SAHS)的关系。方法对经微动敏感床垫睡眠呼吸监测系统检测证实的106例老年SAHS患者以HUA分组,比较分析血尿酸水平、睡眠呼吸紊乱参数、血脂水平及其相互关系。结果与对照组比较,HUA组睡眠呼吸紊乱指数(AHI)增高,P=0.05,主要为低通气指数(HI)明显增高[(10.2±10.2)比(6.4±7.3),P<0.05];HUA组AHI≥15的中重度SAHS患者明显增多(32/44比33/62,χ2=3.960,P<0.05)。而以实时血尿酸水平分组比较,实时HUA组夜间最低血氧饱和度显著低于血尿酸正常组[(75.8±8.6)%比(79.4±6.7)%,P<0.05]。血脂分析显示,HUA组高密度脂蛋白胆固醇(HDL-C)显著低于对照组(P<0.05),三酰甘油(TG)虽高于对照组,但差异无统计学意义;相关性分析显示血尿酸水平与HDL-C呈负相关,与TG呈正相关,分别为r=-0.305,P<0.01;r=0.237,P<0.05。HUA组血尿酸肌酐比值(UA/Cr)显著高于对照组,但未发现血UA/Cr与非同期监测的睡眠呼吸紊乱各参数之间的相关性。结论合并HUA的SAHS患者存在更为严重的睡眠呼吸紊乱和血脂代谢异常,HUA与夜间低氧血症有关。Objective To investigate the relationship betweenhyperuricemia（HUA） and sleep apneahypopnea syndrome（SAHS） in aged patients with cardiovascular disease.Methods The patients with SAHShospitalized due to cardiovascular disease were divided two groups according tohyperuricemia or not.The diagnosis of SAHS was confirmed by sleep monitoring with micro-movement sensitive mattress sleep monitoring system.The data of serum uric acid,lipids,uric acid to creatinine ratio（UA/Cr）,and parameters of sleep-disordered breathing were analyzed.Results Compared with the control group,the number of patients with moderate and severe SAHS apneahypopnea index（AHI） equal or more than 15 was more in HUA group,32 /44 vs 33 /62,χ2= 3.960,P 0.05.The average AHI in HUA group washigher than that in control＇s,P = 0.05,which the increase ofhypopnea index（HI） was mainly contribution to,10.2 ± 10.2 vs 6.4 ± 7.3,P 0.05.When the patients were grouped according to the real time levels of serum uric acid,the significant dicrease of nocturnal lowest saturation of blood oxygen was found in the real time HUA group,（75.8 ± 8.6） % vs（79.4 ± 6.7） %,P 0.05.Analyses of blood lipids showed that the level of serumhigh-density lipoprotein cholesterol（HDL-C） was lower and the level of triacylglycerol（TG） washigher in HUA group than that in the control＇s,but no significance in the latter.The level of serum uric acid was negatively correlated with HDL-C and positvely correlated with TG,r =-0.305,P 0.01,r = 0.237,P 0.05,individually.The UA/Cr in HUA group washigher than that in the control＇s,but nevertheless no correlation was found between UA/Cr and any parameter of sleep-breathing disordered.Conclusion The patients of SAHS complicated HUAhas more serious sleep-breathing disorder and abnormal lipid metabolism than those with normal level of serum uric acid.HUA is correlated with nocturnalhypoxemia.

关 键 词：心血管疾病 睡眠呼吸暂停综合征 高尿酸血症 血脂异常 

分 类 号：R54[医药卫生—心血管疾病]