经皮冠状动脉介入治疗对合并阻塞性睡眠呼吸暂停的冠心病患者睡眠的影响  

Effect of percutaneous coronary intervention on sleep quality of coronary heart disease patients with obstructive sleep apnea syndrome

作　　者：裴志强[1] 苏鑫[1] 武利军 贾保平 王晨[1] 穆景博 白静[1] 马登峰[1] Pei Zhiqiang;Su Xin;Wu Lijun;Jia Baoping;Wang Chen;Mu Jingbo;Bai Jing;Ma Dengfeng(Department of Cardiology,Taiyuan Central Hospital,Taiyuan Cardiovascular Research Institute,Taiyuan 030009,China;Department of Cardiology,PLA 985 Hospital,Taiyuan 030001 China;Department of Cardiology,Shanxi Cardiovascular Diseases Hospital,Taiyuan 030024,China)

机构地区：[1]太原市中心医院心内科,太原市心血管疾病研究所,030009 [2]解放军第九八五医院心内科,太原030001 [3]山西省心血管病医院心内科,太原030024

出　　处：《中华全科医师杂志》2020年第2期127-129,共3页Chinese Journal of General Practitioners

基　　金：山西省卫生和计划生育委员会科研课题(201602007)。

摘　　要：连续入选2016年2月至2018年8月在太原市中心医院、解放军第九八五医院、山西省心血管病医院住院的阻塞性睡眠呼吸暂停(OSA)合并冠心病患者109例,所有患者均行经皮冠状动脉介入治疗(PCI),根据术后睡眠状态有无改善分为观察组(睡眠状态改善)和对照组(睡眠状态无改善)。比较两组患者的临床特点、冠状动脉病变特点。结果显示,PCI术后109例患者有35例(32.1%)睡眠状态发生改善。一般资料比较显示,与对照组比较,观察组男性比例更高[59.5%(44/74)比80.0%(28/35),χ^2=4.471,P=0.035]、吸烟史比例更高[63.5%(47/74)比85.7%(30/35),χ^2=5.647,P=0.018],BMI更低[(27.4±3.2)kg/m^2比(25.8±3.1)kg/m^2,t=2.461,P=0.033];冠状动脉病变结果显示,与对照组比较,观察组冠状动脉Gensini积分更低[(38.7±6.5)分比(35.4±5.7)分,t=2.571,P=0.011]、支架数更少[(1.6±0.4)个比(1.4±0.4)个,t=2.427,P=0.016],且病变部位多分布在右冠状动脉(61.9%,26/35)(χ^2=11.759,P=0.003)。提示冠心病合并OSA的患者行PCI治疗后,术后部分患者睡眠状态改善,且有其自身的临床特点和冠状动脉病变特点。One hundred and nine consecutive coronary heart disease(CHD)patients with obstructive sleep apnea(OSA)undergoing percutaneous coronary intervention(PCI)during February 2016 to August 2018 were enrolled in the study.After treatment the quality of sleep was improved in 35 cases(observation group)and was not improved in 74 patients(control group).The basic characteristics,coronary lesions of patients were compared between two groups.Compared with the control group,patients in observation group had significant higher proportion of males[80.0%(28/35)vs.59.5%(44/74),χ^2=4.471,P=0.035],smoking history[85.7%(30/35)vs.63.5%(47/74),χ^2=5.647,P=0.018],lower body mass index[(25.8±3.1)kg/m^2vs.(27.4±3.2)kg/m^2,t=2.461,P=0.033].Compared with control group,the observation group had lower coronary Gensini score[(35.4±5.7)vs.(38.7±6.5),t=2.571,P=0.011],less number of stent[(1.4±0.4)vs.(1.6±0.4),t=2.427,P=0.016].And the lesions were mostly distributed in the right coronary artery in observation group(61.9%,26/35)(χ^2=11.759,P=0.003).Conclusion The improvement of sleep quality by PCI depends on the clinical features and coronary artery lesions of CHD patients with OSA.

关 键 词：睡眠呼吸暂停 阻塞性 冠心病 冠状动脉介入治疗 睡眠 

分 类 号：R76[医药卫生—耳鼻咽喉科] R541[医药卫生—临床医学]