阻塞性睡眠呼吸暂停低通气综合征对非体外循环下冠状动脉旁路移植术患者心功能的影响  

The impact of obstructive sleep apnea hypopnea syndrome on heart function in patients undergoing off pump coronary artery bypass graft surgery

作　　者：高铭鑫[1] 王鹏程 于文渊[1] 唐田 顾承雄[1] 于洋[1] 魏永祥[2] GAO Mingxin;WANG Pengcheng;WANG Jiayang;YU Wenyuan;TANG Tian;ZHANG Fan;QIAO Ruiguo;GU Chengxiong;WANG Li;YU Yang;WEI Yongxiang(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心脏外科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所耳鼻喉头颈外科,100029

出　　处：《心肺血管病杂志》2020年第1期34-39,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国际科技合作项目(2015DFA30160);北京市科委绿色通道重点项目(Z141100006014057);登峰人才项目(DFL20150602)。

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)在非体外循环下冠状动脉旁路移植术(OPCABG)患者中的患病率及其对患者心功能的影响。方法:本研究为前瞻性观察性研究;纳入2018年1月至2018年12月,在首都医科大学附属北京安贞医院行OPCABG手术患者101例;术前行便携式睡眠呼吸监测;根据呼吸暂停指数(AHI)分为轻度或无OSAHS患者和中重度OSAHS患者,比较两组患者基线资料、合并症、血液学检查、心功能检查、睡眠呼吸检查等指标。结果:根据入选及排除标准共入组74例OPCABG手术患者为研究对象,男性60例,平均年龄(61.1±7.2)岁,BMI(25.7±2.3)kg/m2,合并中重度OSAHS(AHI≥15)的OPCABG患者占总人数52.7%;合并中-重度OSAHS的OPCABG患者中男性和吸烟史比例高于合并轻度或无OSAHS患者(男性:92.3%vs.68.6%,P=0.009;吸烟史:66.7%vs.42.9%,P=0.04);二元Logistic回归分析显示,合并不同程度OSAHS的OPCABG患者射血分数(OR=0.922,95%CI:0.86~0.99,P=0.022)差异有统计学意义。结论:中-重度的OSAHS患者在OPCABG手术患者中发病率较高;OSAHS严重影响OPCABG患者的心功能。Objective:To study the prevalence of obstructive sleep apnea hypopnea syndrome(OSAHS)in patients undergoing off-pump coronary artery bypass grafting(OPCABG)and the impact of OSAHS on heart function.Methods:This prospective study included 74 patients undergoing OPCABG in Beijing An Zhen hospital from January 2015 to December 2015.OSAHS was evaluated with a portable sleep monitor before OPCABG.Results:There were 74 patients[60 men,mean age(61.1±7.2)years,BMI(25.7±2.3)kg/m2]entering two groups.The prevalence of moderate-severe OSAHS(AHI≥15)in the patients was 52.7%(39/74).The moderate-severe group had significantly higher proportion of men(92.3%vs.68.6%,P=0.009),higher percentage of a cigarette-smoking history(66.7%vs.42.9%,P=0.04),but lower ejection fraction[(56.0±9.2)vs.(61.5±9.2),P=0.013].Multivariate logistic regression analysis revealed ejection fraction(OR=0.922;95%CI:0.86-0.99;P=0.022)was significant protective and risk factors for OSAHS,respectively.Conclusions:OSAHS appears prevalent and at moderate-severe stage in patients undergoing OPCABG.Patients with severe OSAHS may highly likely have low ejection fraction and poor heart function.

关 键 词：非体外循环下冠状动脉旁路移植术 阻塞性睡眠呼吸暂停低通气综合征 患病率 心功能 

分 类 号：R54[医药卫生—心血管疾病]