心脏远程监护仪监测指标与阻塞性睡眠呼吸暂停低通气综合征严重程度的关系  

The Relationship between Monitoring Indexes of Cardiac Remote Monitor and the Severity of Obstructive Sleep Apnea-hypopnea Syndrome

作　　者：桂金杰 刘丽丽[1] 李慧敏[1] 赖丽娟 钟立芳 GUI Jinjie;LIU Lili;LI Huimin;LAI Lijuan;ZHONG Lifang(Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市人民医院,江西赣州341000

出　　处：《中国医学创新》2023年第12期30-34,共5页Medical Innovation of China

基　　金：江西省卫生健康委普通科技计划项目(202212504)。

摘　　要：目的:探讨心脏远程监护仪(iHolter)监测指标与阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)严重程度的关系。方法:选取2019年5月-2021年10月在赣州市人民医院125例OSAHS患者作为研究组,所有患者根据睡眠呼吸监测结果分为轻度组(n=42)、中度组(n=47)和重度组(n=36),另选取同期非OSAHS患者45例作为对照组。所有患者均随身佩戴心脏远程监护仪iHolter,记录并比较各组患者体重指数(BMI)、Epworth嗜睡量表(ESS)、呼吸紊乱指数(AHI)、睡眠紊乱指数(RDI)、最低血氧饱和度(LSaO_(2))和心电异常情况发生率。结果:重度组OSAHS患者的BMI均高于对照组、轻度组和中度组(P<0.05)。重度组OSAHS患者的ESS评分、AHI、RDI均高于对照组、中度组和轻度组,且中度组均高于轻度组和对照组,轻度组均高于对照组,重度组OSAHS患者的LSaO_(2)均低于对照组、中度组和轻度组,且中度组均低于轻度组和对照组,轻度组均低于对照组(P<0.05)。研究组患者中共计92例(73.6%)发现心电异常,对照组11例(24.4%)。两组心电异常比例比较,差异有统计学意义(χ^(2)=33.482,P=0.000)。研究组中、重度组室性早搏、房性心律失常、ST-T段改变、房室传导阻滞发生率均较轻度组升高(P<0.05)。结论:iHolter监测指标异常情况与OSAHS患者病情有关,能帮助早期识别中重度患者,可为临床早期干预提供依据。Objective:To explore the relationship between monitoring indexes of the cardiac remote monitor(iHolter)and the severity of obstructive sleep apnea-hypopnea syndrome(OSAHS).Method:A total of 125 patients with OSAHS in Ganzhou People's Hospital from May 2019 to October 2021 were selected as the study group,according to sleep breathing monitoring results,all patients were divided into mild group(n=42),moderate group(n=47)and severe group(n=36),another 45 patients without OSAHS during the same period were selected as control group.All patients wore remote cardiac monitor iHolter,body mass index(BMI),Epworth sleepiness scale(ESS),apnea hypopnea index(AHI),respiratory disturbance index(RDI),lowest arterial oxygen saturation(LSaO_(2))and the incidence of ECG abnormalities were recorded and compared in each group.Result:The BMI of severe group OSAHS patients was higher than that of control group,mild group and moderate group(P<0.05).ESS scores,AHI and RDI of OSAHS patients in severe group were higher than those of control group,moderate group and mild group,those of moderate group were higher than those of mild group and control group,and those of mild group were higher than those of control group,the LSaO_(2) of OSAHS patients in severe group was lower than that of control group,moderate group and mild group,and that of moderate group was lower than that of mild group and control group,that of mild group was lower than that of the control group(P<0.05).A total of 92 patients(73.6%)in the study group and 11 patients(24.4%)in the control group were found to have ECG abnormalities.The proportion of ECG abnormalities between the two groups was statistically significant(χ^(2)=33.482,P=0.000).The incidences of ventricular premature beats,atrial arrhythmias,ST-T segment changes and atrioventricular block in the moderate group and severe group were higher than those in the mild group(P<0.05).Conclusion:The abnormality of iHolter monitoring indicators is related to the condition of OSAHS patients,which can help early identify m

关 键 词：阻塞性睡眠呼吸暂停综合征 心律失常 心率变异性 

分 类 号：R766[医药卫生—耳鼻咽喉科]