阻塞性睡眠呼吸暂停综合征患者左室几何构型与肺动脉僵硬度的相关性  

Correlation between left ventricular geometry and pulmonary artery stiffness in patients with obstructive sleep apnea syndrome

作　　者：田云 水雯[1] 张勇[1] 冯晓丽 康彩虹 崔桐 王健[1] TIAN Yun;SHUI Wen;ZHANG Yong;FENG Xiaoli;KANG Caihong;CUI Tong;WANG Jian(Department of Ultrasound,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院超声科,太原市030001

出　　处：《临床超声医学杂志》2022年第5期368-373,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者左室几何构型与肺动脉僵硬度(PAS)的相关性。方法选取我院经多导睡眠呼吸监测确诊的OSAS患者137例,依据超声心动图所测左室质量指数(LVMI)和相对室壁厚度(RWT)分为正常构型组69例、向心性重构组29例、离心性肥厚组21例、向心性肥厚组18例;另选同期健康志愿者35例作为对照组。应用超声心动图检测左室舒张末期内径(LVDd)、左室射血分数(LVEF)、LVMI、RWT、二尖瓣舒张早晚期血流速度峰值比值(E/A)、肺动脉血流最大频移(MFS)、肺动脉加速时间(PAcT),并计算PAS,比较各组上述参数差异;分析PAS与一般资料及超声心动图参数的相关性,并进一步行多元线性回归分析。结果各组LVDd、RWT、LVMI、E/A、MFS、PAcT、PAS比较,差异均有统计学意义(均P<0.05);与对照组比较,OSAS各组PAS均增加,向心性重构组、离心性肥厚组、向心性肥厚组PAcT均减小,差异均有统计学意义(均P<0.05);与正常构型组比较,向心性重构组RWT、LVMI、MFS、PAS均增加,离心性肥厚组、向心性肥厚组LVDd、LVMI、MFS、PAS均增加,E/A均减小,差异均有统计学意义(均P<0.05);与向心性重构组比较,离心性肥厚组和向心性肥厚组LVDd、LVMI均增加,离心性肥厚组RWT减小,向心性肥厚组E/A减小、PAS增加,差异均有统计学意义(均P<0.05);与离心性肥厚组比较,向心性肥厚组RWT和PAS均增加,LVDd减少,差异均有统计学意义(均P<0.05)。PAS与年龄、体质量指数、收缩压、舒张压、呼吸暂停低通气指数(AHI)、LVMI、RWT、左室几何构型均呈正相关(r=0.154、0.166、0.253、0.153、0.336、0.276、0.286、0.433,均P<0.05),与夜间最低血氧饱和度呈负相关(r=-0.158,P<0.05)。多元线性回归分析显示,PAS与年龄、AHI、左室几何构型均独立相关(均P<0.05)。结论OSAS患者左室几何构型与PAS独立相关,是其独立影响因素之一。ObjectiveTo investigate the relationship between left ventricular geometry and pulmonary artery stiffness(PAS)in patients with obstructive sleep apnea syndrome(OSAS).Methods polysomnography were selected and divided into 4 groups according to left ventricular mass index(LVMI)and relative wall thickness(RWT)measured by echocardiography.There were 69 cases in the normal geometry group,29 cases in the concentric remodeling group,21 cases in the eccentric hypertrophy group,and 18 cases in the concentric hypertrophy group.Another 35healthy volunteers were selected as control group.Left ventricular end-diastolic diameter(LVDd),left ventricular ejection fraction(LVEF),LVMI,RWT,the ratio of early diastolic mitral flow velocity to late diastolic mitral flow velocity(E/A),maximum frequency shift of pulmonary arterial flow(MFS),and pulmonary arterial acceleration time(PAcT)were measured by echocardiography,and PAS was calculated.The differences of above parameters in each group were compared.Correlation analysis was used to analyze the relationship between PAS and general data,echocardiographic parameters,and multiple linear regression analysis was performed.Results PAS among all groups(all P<0.05).Compared with the control group,PAS was increased in OSAS groups,PAcT was decreased in the concentric remodeling group,eccentric hypertrophy group and concentric hypertrophy group(all P<0.05).Compared with the normal geometry group,RWT,LVMI,MFS and PAS were increased in the concentric remodeling group,LVDd,LVMI,MFS and PAS were increased in the eccentric hypertrophy group and concentric hypertrophy group,while E/A was decreased,the differences were statistically significant(all P<0.05).Compared with concentric remodeling group,LVDd and LVMI were increased in eccentric hypertrophy group and concentric hypertrophy group,RWT was decreased in eccentric hypertrophy group,E/A was decreased and PAS was increased in concentric hypertrophy group,and the differences were statistically significant(all P<0.05).Compared with eccentric hypertr

关 键 词：超声心动描记术 阻塞性睡眠呼吸暂停综合征 肺动脉僵硬度 左室几何构型 

分 类 号：R540.45[医药卫生—心血管疾病] R563.8[医药卫生—内科学]