动态心电图筛查睡眠呼吸暂停综合征在冠心病中的应用  

Application of dynamic electrocardiogram for screening sleep apnea syndrome in coronary heart disease

作　　者：王蕊[1] 林晖[1] 王德昭[1] 杜凤和[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050

出　　处：《检验医学与临床》2016年第5期623-624,627,共3页Laboratory Medicine and Clinic

摘　　要：目的应用动态心电图(DCG)观察冠心病(CHD)患者中睡眠呼吸暂停综合征(SAS)的发生情况,分析SAS与CHD及其危险因素之间的关系。方法选取因胸痛于本院心内科住院并行冠状动脉造影检查的患者共166例,根据造影结果分为CHD组和对照组。所有患者均进行DCG检查,并应用DCG筛查SAS。结果 166例患者中确诊CHD100例(CHD组),66例除外CHD(对照组)。CHD组的男/女性别比例高于对照组,差异有统计学意义(P<0.05),年龄、腹围、糖尿病患病率、估计的呼吸暂停低通气指数(Est.AHI)、SAS发生率亦明显高于对照组,差异有统计学意义(P<0.01)。CHD组有38.0%合并SAS,而对照组SAS的发生率仅为18.2%。Logistic回归分析显示Est.AHI水平、性别、年龄与CHD发病独立相关,且危险性从大到小依次为Est.AHI水平、年龄和性别。结论 CHD患者中SAS的发生率较高,SAS是CHD的独立危险因素;应用DCG筛查CHD患者中的SAS是可行的,具有一定的临床实用价值。Objective To apply the dynamic electrocardiogram（DCG）to observe the occurrence situation of sleep apnea syndrome（SAS）in the patients with coronary heart disease（CHD）and to analyze the relation between SAS with CHD and its risk factors.Methods 166 inpatients with chest pain and undergone coronary angiography in the cardiology department of our hospital were selected and divided into the CHD group and the control group according to the coronary angiography results.All patients underwent DCG inspection and SAS was screened with DCG.Results Among 166 inpatients,100cases of CHD were diagnosed（CHD group）and 66 cases were excluded CHD（control group）.The CHD group showed higher male/female ratio than that in control group（P〈0.05）.The age,abdominal circumference,diabetes mellitus incidence rate,estimated apnea-hypopnea index（Est.AHI）and SAS incidence in the CHD group were also significantly higher than those in the control group（P〈0.01）.38.0% of patients in the CHD group were accompanied with SAS,while the SAS occurrence rate in the control group was only18.2%.The multiple Logistic regression analysis revealed that the Est.AHI level,gender and age were independently correlated with the CHD incidence,moreover the risk from high to low was in turn the Est.AHI level,age and gender.Conclusion The prevalence of SAS in CHD patients is very frequent,and SAS is an independent risk factor of CHD.DCG is available for screening SAS in CHD patients.

关 键 词：冠心病 睡眠呼吸暂停综合征 动态心电图 危险因素 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]