睡眠期心律失常对血氧饱和度影响的临床研究  

Effect of Arrhythmia on Changes in Blood Oxygen Saturation during Sleep Period

作　　者：张硕[1] 王钊[1] 朱浩杰 吴征瑜 樊晓寒[1] ZHANG Shuo;WANG Zhao;ZHU Haojie;WU Zhengyu;FAN Xiaohan(State Key Laboratory of Cardiovascular Disease,Cardiac Arrhythmia Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beiing 100037,Beijing,China;Shenzhen Novocare Medical Technology Co.,Inc,Shenzhen 518000,Guangdong,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心律失常中心心血管病国家重点实验室,北京市100037 [2]深圳诺康医疗科技股份有限公司,深圳市518000

出　　处：《中国分子心脏病学杂志》2022年第2期4534-4539,共6页Molecular Cardiology of China

基　　金：睡眠期心律失常与血氧饱和度关系的临床研究(2016-ZX23)。

摘　　要：目的探索睡眠期不同心律失常类型发生对血氧饱和度的影响。方法连续收集2017年11月至2019年10月有或无心律失常且接受NS1S无扰心电和血氧监测的患者,共纳入心律失常患者86例(男51例),正常对照者34例(男18例)。心律失常组患者按照心律失常类型的不同,又分为持续心房颤动(AF)组、病态窦房结综合征(SSS)组及频发室性期前收缩(VPC)组。其中AF组36例(男30例),SSS组17例(男7例),VPC组33例(男14例)。收集心律失常组及健康对照组睡眠期平均血氧饱和度(SpO_(2平均))、最小血氧饱和度(SpO_(2小))、心率(HR)、收缩压(SBP)及舒张压(DBP)进行对比分析。以SpO_(2平均)、SpO_(2小)为检验指标,绘制受试者操作特征(ROC)曲线,分析其对心律失常发生预测准确的临界值,观察心律失常组及其各亚组小于临界值的例数及比例。结果心律失常组的SpO_(2平均)、SpO_(2小)明显低于健康对照组(P<0.05)。AF组、SSS组、VPC组三组间两两对比,SpO_(2平均)、SpO_(2小)、SBP、DBP无明显差异(P>0.05)。AF组、SSS组、VPC组分别与健康对照组比较,SpO_(2平均)、SpO_(2小)均显著降低(P<0.05)。以SpO_(2平均)、SpO_(2小)预测心律失常发生绘制ROC曲线,SpO_(2平均)的AUC为0.825,临界值为98.1%(P<0.05);SpO_(2小)的AUC为0.821,临界值为97.5%(P<0.05)。心律失常组低于SpO_(2平均)临界值者为75例(87.2%),其中AF组31例(86.1%),SSS组14例(82.4%),VPC组30例(90.9%)。心律失常组低于SpO_(2小)临界值者为69例(80.2%),其中AF组29例(80.6%),SSS组14例(82.4%),VPC组26例(78.8%)。结论心律失常患者睡眠期可出现SpO_(2平均)、SpO_(2小)降低,AF、SSS、VPC三种心律失常出现血氧饱和度降低的概率无明显区别。Objective To explore the effect of different arrhythmia types on changes in blood oxygen saturation during sleep period.Methods The cases with or without arrhythmia who accepted undisturbed ECG and blood oxygen monitoring by NS1S were continuously collected from November 2017 to October 2019.A total of 86 cases with arrhythmia(51 males)and 34 normal controls(18 males)were enrolled.Among the cases of arrhythmia,there were 36 patients in AF group(30 males),17 patients in SSS group(7 males)and 33 patients in VPC group(14 males).Then those cases were divided into arrhythmia group(group A)and control group(group C).The cases in group A were divided into persistent atrial fibrillation group(AF group),sick sinus syndrome group(SSS group)and frequent ventricular premature contraction group(VPC group).The average blood oxygen saturation(SpO_(2average)),minimum blood oxygen saturation(SpO_(2min)),heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were compared between group A and group C in the sleep period.SpO_(2average) and SpO_(2min) were analyzed with receiver operating characteristic(ROC)curve to get the cut-off value to predict the occurrence of arrhythmia.Due to cut-off value of ROC curve,the number and proportion of group A and three sub-groups which was lower than the cut-off value were calculated.Results SpO_(2average) and SpO_(2min) in group A were significantly lower than that in group C(P<0.05).There was no significant difference between AF group,SSS group and VPC group in SpO_(2average),SpO_(2min),SBP and DBP(P>0.05).There were statistically significantly differences between the each subgroup and group C in SpO_(2average) and SpO_(2min)(P<0.05).SpO_(2average) and SpO_(2min) were analyzed with receiver operating characteristic(ROC)curve to predict the occurrence of arrhythmia.The area under the curve(AUC)of SpO_(2average) and SpO_(2min) were 0.825 and 0.821,and the cut-off values were 98.1%and 97.5%(P<0.05).The number(proportion)of cases in group A and the three subgroups(AF group,SSS

关 键 词：睡眠期 心律失常 血氧饱和度 临床研究 

分 类 号：R541.7[医药卫生—心血管疾病]