西宁地区慢性高原病患者心脏功能改变与睡眠质量的相关性  

The correlation between cardiac function change and sleep quality in patients with chronic mountain sickness in Xining area

作　　者：袁新[1] 吴泽涛[2] 扎洛[3] Yuan Xin;Wu Zetao;Zalo(Department of Health Management,Qinghai People's Hospital,Xining 810007,China)

机构地区：[1]青海省人民医院健康管理部,西宁810007 [2]青海省人民医院介入科,西宁810007 [3]青海红十字医院

出　　处：《中华保健医学杂志》2019年第4期305-308,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨西宁地区慢性高原病(chronic mountain sickness,CMS)患者睡眠质量与心脏功能改变的相关性。方法以整群抽样方式选取2017年1月~ 12月西宁地区60例CMS患者为观察组,选择同期西宁地区60例非CMS患者为对照组。比较两组心脏功能、睡眠结构与睡眠质量,经双变量Pearson相关性检验分析患者睡眠质量与心功能改变的相关性。结果观察组射血分数(EF)、心搏量(SV)、收缩末期容量(ESV)与对照组比较,差异无统计学意义(P > 0.05);右心室舒张末容量(RVEDV)、室壁质量(RVM)、右室侧壁厚度(RVT)、右室乳头肌质量(RVPM)、对比剂达峰值时间(TTP)、对比剂达50%峰值时间(50%TTP)均较对照组升高,信号-时间上升支斜率(MUS)、左室相对强化比(LVRMUS)、峰值信号强度(PE)较对照组降低,差异具有统计学意义(P < 0.05)。观察组觉醒指数、快动眼睡眠(REM)占总睡眠比、非快动眼睡眠(nREM)睡眠1期及2期占总睡眠比、匹兹堡睡眠质量指数(PSQI)评分均较对照组升高,总睡眠时间、睡眠效率、nREM睡眠3、4期占总睡眠比均较对照组降低,差异具有统计学意义(P < 0.05)。经双变量Pearson相关性分析证实,患者PSQI评分与RVEDV、RVW、RVT、RVPM、50%TTP、TTP呈正相关(r > 0,P < 0.05),与MUS、LVRMUS、PE呈负相关(r < 0,P < 0.05)。结论西宁地区CMS患者心脏功能结构发生改变,心肌代谢缓慢,患者常伴不同程度睡眠障碍,其心功能异常与睡眠障碍间可能相互作用,临床在重视患者心功能变化治疗的同时,还应重视评估患者睡眠质量并采取合理干预,减少睡眠障碍的发生,对改善患者心功能异常意义重大。Objective To analyze the correlation between sleep quality and cardiac function changes in CMS patients in Xining region. Methods 60 CMS patients in Xining region from January 2017 to December 2017 were selected by cluster sampling as observation group,and 60 non-CMS patients in Xining region were selected as control group. The cardiac function,sleep structure and sleep quality were compared between the two groups. The correlation between sleep quality and cardiac function changes was analyzed by bivariate Pearson correlation test. Results There was no statistical difference in the ejection fraction (EF),stroke volume (SV),end-systolic volume (ESV) between observation group and control group (P > 0.05);The right ventricular end-diastolic volume (RVEDV),recovery voltage meter (RVM),right ventricular thickness (RVT),right ventricular papillary mass (RVPM),time to 50% peak (50%TTP),time to peak (TTP) in observation group were higher than those in control group,while the maximum upslope (MUS),left ventricular relative maximum (LVRMUS),peak enhanced (PE) in observation group were lower than those in control group (P < 0.05);The arousal index,ratio of rapid eye movement (REM) sleep in total sleep,ratio of stage 1 and 2 non-rapid eye movement (nREM) sleep in total sleep,Pittsburgh sleep quality index (PSQI) score in observation group were higher than those in control group,while the total sleep time,sleep efficiency,ratio of stage 3 and 4 nREM sleep in total sleep in observation group were lower than those in control group (P < 0.05);The bivariate Pearson correlation confirmed that the PSQI score had positive correlation with RVEDV,RVM,RVT,RVPM,50%TP,TTP (r > 0,P < 0.05),and had negative correlation with MUS,LVRMUS,PE (r < 0. P < 0.05). Conclusion The CMS patients exist cardiac function structural change,slow myocardial metabolism and sleep structure disorder,and their cardiac function abnormalities may interact with sleep disorders. Clinically,it is necessary to pay attention to the treatment of cardiac function change

关 键 词：慢性高原病 心脏功能 睡眠质量 

分 类 号：R594.3[医药卫生—内科学]