重度阻塞性睡眠呼吸暂停对冠心病患者预后的影响  

Effect of Severe Obstructive Sleep Apnea on the Prognosis of CHD Patients

作　　者：罗剑静 刘琳 冼沛勤 梁国泉 杨澄 LUO Jiajing;LIU Lin;XIAN Peiqin;LIANG Guoquan;YANG Cheng(Medical Medicine Teaching and Research Section of Zhaoqing Medical College,Zhaoqing 526020,China;Zhaoqing Second People's Hospital,Zhaoqing 526060,China;the Affiliated Hospital of Zhaoqing Medical College,Zhaoqing 526020,China)

机构地区：[1]肇庆医学高等专科学校内科教研室,广东肇庆526020 [2]肇庆市第二人民医院,广东肇庆526060 [3]肇庆医学高等专科学校附属医院,广东肇庆526020

出　　处：《中国医药指南》2022年第35期72-75,共4页Guide of China Medicine

基　　金：2020年肇庆市科技创新指导类项目(202004030717)。

摘　　要：目的探讨合并重度阻塞性睡眠呼吸暂停(OSA)对冠心病患者预后的影响。方法拟于2020年6月至2022年2月选取肇庆市第二人民医院心内科收治的60例合并OSA的冠心病患者为研究对象。根据呼吸暂停低通气指数(AHI)将60例合并OSA患者分为:重度OSA组、中度OSA组、轻度OSA组。记录心血管不良事件(MACE)发生率及生存率,采用Cox回归模型分析患者预后的影响因素。结果重度OSA组MACE发生率高于中度、轻度OSA组,中度OSA组高于轻度OSA组;重度OSA组生存率低于中度、轻度OSA组,中度OSA组低于轻度OSA组(P<0.05)。多因素Cox回归分析显示,OSA严重程度、年龄、体质量指数(BMI)、谷丙转氨酶(ALT)升高,HDL-C、最低血氧饱和度下降为冠心病患者发生MACE的独立危险因素(P<0.05)。结论合并OSA的冠心病患者MACE发生率随OSA严重程度呈递增趋势,重度OSA为冠心病患者发生MACE的独立危险因素。Objective To investigate the effect of severe obstructive sleep apnea(OSA)on patients with coronary heart disease.Methods Sixty patients with OSA admitted to cardiology Department of Zhaoqing Second People's Hospital from June 2020 to February 2022.According to the apnea hypopnea index(AHI),60 patients with OSA were divided into:severe OSA group,moderate OSA group and mild OSA group.The incidence and survival rate of cardiovascular adverse events(MACE)were recorded,and the factors affecting patient outcomes were analyzed by using the Cox regression model.Results The incidence of MACE in severe OSA was higher than moderate and mild OSA,moderate OSA than mild OSA;severe OSA was lower than moderate and mild OSA,and moderate OSA than mild OSA(P<0.05).Multivariate Cox regression analysis showed that OSA severity,age,body mass index(BMI),alanine transaminase(ALT)were increased,and HDL-C and minimum oxygen saturation decreased were independent risk factors for MACE in CHD patients(P<0.05).Conclusion The incidence of MACE patients with OSA increases with OSA severity,and severe OSA is an independent risk factor for MACE in CAD patients.

关 键 词：冠心病 阻塞性睡眠呼吸暂停 血气分析 不良心脑血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]