阻塞性睡眠呼吸暂停综合征与心脑血管病的关系  

Relations between obstructive sleep apnea syndrome and cardio-cerebrovascular disease

作　　者：陈新华[1] 彭化生[2] 刘心臣[1] 朱明[1] 董卫平 周桂明 

机构地区：[1]菏泽医学专科学校神经病学教研室,山东省菏泽市274030 [2]菏泽市第三人民医院神经科 [3]菏泽医学专科学校附属医院神经科

出　　处：《中华神经科杂志》2002年第5期275-278,共4页Chinese Journal of Neurology

摘　　要：目的　分析阻塞性睡眠呼吸暂停综合征 (OSAS)相关事件与心、脑血管病发病关系 ,探讨其发病机制。方法　对健康体检者和专科门诊就诊者进行问卷调查 ,采用多导睡眠图 (PSG)监测 ,筛查出OSAS患者 2 6 2例 ,选择同期 2 4 0名健康体检者作为对照组。观察血压、血糖、血脂、血浆降钙素基因相关肽 (CGRP)、内皮素 (ET)等指标 ,并对心、脑血管病发病情况进行了 6个月至 3年的随访。结果　 (1)OSAS组PSG监测 ,呼吸紊乱次数 35 8 0± 37 0、呼吸紊乱指数 5 9 0± 11 0、平均呼吸暂停时间 (35 0± 13 0 )s、最长呼吸暂停时间 (6 8 0± 2 7 0 )s及 2 4h平均动脉压 (12 8 7± 12 8)mmHg均明显高于对照组 (P <0 0 1) ;最低血氧饱和度 (5 6 %± 13% )明显低于对照组 (P <0 0 1)。 (2 )OSAS组血糖、血脂、纤维蛋白原、血浆ET均高于对照组 (P <0 0 1) ;血浆CGRP明显低于对照组 (P <0 0 1)。 (3)OSAS患者随着病程的延长 ,心、脑血管病发病率逐年增加 ,且均高于对照组 (P <0 0 1)。随访 3年时 ,OSAS组心血管病患病率 6 7 78% ;脑血管病患病率 4 5 6 1%。 (4)OSAS组患者心、脑血管病的发生与呼吸紊乱指数、血压、血糖、纤维蛋白原呈正相关。结论　OSAS与心、脑血管病的发病有密切关系 ,是长期以来尚未引起足够重视?Objective To analyze the relation between obstructive sleep apnea syndrome (OSAS) and cardio cerebrovascular disease as to exploring its mechanisms and preventive methods Methods The patients who have a general health check up and have a visit to clinic were investigated by filling a questionnaire The patients with PSG have been monitored to select patients from those of OSAS And a control group was established Hypertension, blood fat, blood plasma CGRP, ET and other indexes were observed Patients with cardio cerebrovascular disease were visited in a period from six months to three years Results (1)PSG monitor, RDN (358±37), AHI (59±11), OSAT (35±13) s, LOSAT (68±27) s and average hypertension(128 7±12 8) mm Hg in OSAS group were found obviously higher than those in the control group ( P <0 01); and the lowest SatO 2 % (56±13)%, was obviously lower than those in control group (2)Blood sugar, blood fat, fibroprotein, and blood plasma ET CGRP in OSAS group were obviously higher than those in control group ( P <0 01), and blood plasama CGRP was obviously lower than it in the control group ( P <0 01) (3) 162 cases of cardiovascular disease in OSAS group, had an attack rate of 67 78%, while in 109 cases of cerebrovascular disease, the attack rate was 45 61% (4) There were close relations between the attack rate of cerebro vascular disease in OSAS patients and the AHI, SH, hypertension, number of red blood cells and blood viscosity Conclusion It is suggested that there appear some close relations between OSAS and cardio cerebrovascular disease and it should be a risk factor worth while to put emphasis on prevention and treatment of cardio cerebrovascular disease

关 键 词：阻塞性睡眠呼吸暂停综合征 心脑血管病 内皮素 多导睡眠图 内皮缩血管相关肽 CGRD 

分 类 号：R766[医药卫生—耳鼻咽喉科]