阻塞性睡眠呼吸暂停综合征与冠状动脉狭窄病变严重程度的关系  

The relationship between obstructive sleep apnea syndrome and the severity of coronary artery stenosis

作　　者：段雯[1] 潘莹[1] 曾宪钦[1] 张志远[1] 

机构地区：[1]深圳市龙岗区人民医院心内科,深圳518172

出　　处：《新医学》2015年第3期168-171,共4页Journal of New Medicine

摘　　要：目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）与冠状动脉狭窄病变的关系。方法选择经冠脉造影确诊冠状动脉粥样硬化性心脏病（冠心病）并伴打鼾史的患者132例进行睡眠呼吸监测,根据睡眠呼吸暂停低通气指数（AHI）分为对照组（非OSAS组）、冠心病合并OSAS组,根据AHI的水平分为轻度OSAS组（AHI=5~15次/小时）、中度OSAS组（AHI=16~30次/小时）、重度OSAS组（AHI〉30次/小时）,比较各组间冠状动脉狭窄病变情况及严重程度与AHI的关系。结果冠心病合并OSAS组患者的冠状动脉血管病变支数所占比例均明显高于非OSAS组,比较差异有统计学意义（F=112.962,P〈0.01）;4组的TIMI血流情况比较差异有统计学意义（Hc=22.150,P〈0.01）;4组的SYNTAX评分比较差异亦有统计学意义（F=328.113,P〈0.01）。冠状动脉病变严重程度SYNTAX评分与AHI呈正相关（r=0.862,P〈0.01）。结论 OSAS的严重程度可反映冠状动脉狭窄病变的严重程度,提高对OSAS的认知和干预是对冠心病预防与治疗的重要途径。Objective To discuss the relationship between obstructive sleep apnea syndrome（ OSAS） and coronary artery stenosis. Methods In total,132 patients diagnosed with coronary heart disease（ CHD） by coronary angiography and snoring were examined with polysomnography. All patients were divided into the control（ non-OSAS） and the study groups（ CHD ＋ OSAS） according to the apnea hypopnea index（ AHI）. Patients in the study group were classified into the mild（ AHI = 5-15 times/hour）,moderate（ AHI =16-30 times / hour） and severe（ AHI〉 30 times / hour） OSAS groups. The relationship between the severity of coronary artery stenosis and AHI was statistically compared among different groups. Results The percentage of coronary artery vascular lesions in the study group was significantly higher than that in the control group（ F= 112. 962,P〈0. 01）. The blood flow detected by TIMI grade significantly differed among four groups（ Hc=22. 150,P〈0. 01）. The SYNTAX scores were significantly different among four groups（ F = 328. 113,P〈0. 01）. The severity of coronary artery stenosis（ SYNTAX score） was positively correlated with AHI（ r =0. 862,P〈0. 01）. Conclusions The severity of OSAS could reflect the degree of coronary artery stenosis.Enhancing the understanding and interference of OSAS is a pivotal approach of prevention and treatment of CHD.

关 键 词：阻塞性睡眠呼吸暂停综合征 睡眠呼吸暂停低通气指数 冠状动脉狭窄病变 SYNTAX评分 

分 类 号：R766[医药卫生—耳鼻咽喉科] R541.4[医药卫生—临床医学]