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 Prognosis of Patients with Coronary Heart Disease

作　　者：罗剑静 梁国泉 刘琳肇 冼沛勤 杨澄[1] LUO Jianjing;LIANG Guoquan;LIU Linzhao;XIAN Peiqin;YANG Cheng(Zhaoqing Medical College,Zhaoqing 526020,China;Internal Medicine of Zhaoqing Second People′s Hospital,Zhaoqing 526060,China)

机构地区：[1]肇庆医学高等专科学校,肇庆526020 [2]肇庆市第二人民医院内科,肇庆526060

出　　处：《世界睡眠医学杂志》2023年第10期2468-2470,共3页World Journal of Sleep Medicine

摘　　要：目的:探讨重度阻塞性睡眠呼吸暂停对冠心病患者预后产生的影响。方法:选取2020年6月至2021年2月肇庆医学高等专科学校附属医院内科和急诊科及肇庆市第二人民医院心血管内科收治的冠心病患者60例作为研究对象,按照呼吸暂停低通气指数分为A1组(冠心病合并轻度阻塞性睡眠呼吸暂停综合征组18例)、A2组(冠心病合并中度阻塞性睡眠呼吸暂停综合征组29例)以及A3组(冠心病合并重度阻塞性睡眠呼吸暂停综合征组13例);对所有患者入院后同型半胱氨酸(Hcy)、血浆髓过氧化物酶(MPO)、三酰甘油(TG)以及高敏C反应蛋白(hs-CRP)的水平进行检测,对心肌缺血总负荷(TIB)进行计算,对患者冠脉造影检查后Gensini评分进行评估。在出院后针对患者实施为期1年的随访,对其心血管不良事件发生率进行统计。结果:随着阻塞性睡眠呼吸暂停综合征严重程度增加,患者Hcy、MPO、TG以及hs-CRP水平呈现出显著提升。其中A2组Hcy、MPO、TG以及hs-CRP水平均高于A1组(均P<0.05);A3组Hcy、MPO、TG以及hs-CRP水平均高于A2组(均P<0.05)。伴随阻塞性睡眠呼吸暂停综合征疾病严重程度增加,患者Gensini评分以及TIB均呈现出显著提升,A2组Gensini评分以及TIB均高于A1组(均P<0.05);A3组Gensini评分以及TIB均高于A2组(均P<0.05);A3组心血管不良事件发生率高于A2组以及A1组(均P<0.05)。结论:冠心病患者合并重度阻塞性睡眠呼吸暂停综合征疾病后,会对其病变程度以及预后水平产生严重影响。Objective:To investigate the effect of severe obstructive sleep apnea on the prognosis of patients with coronary heart disease.Methods:From June 2020 to February 2021,60 patients with coronary heart disease who were admitted to the Internal Medicine and Emergency Department of Zhaoqing Medical College and the Cardiovascular Medicine Department of Zhaoqing Second People′s Hospital were selected as the research objects.According to the apnea hypopnea index,they were divided into A1 group(18 cases of coronary heart disease combined with mild obstructive sleep apnea syndrome group),A2 group(29 cases of coronary heart disease combined with moderate obstructive sleep apnea syndrome group),and A3 group(13 cases of coronary heart disease combined with severe obstructive sleep apnea syndrome group).The levels of homocysteine(Hcy),plasma myeloperoxidase(MPO),triglycerides(TG),and high-sensitivity C-reactive protein(hs CRP)were detected in all patients after admission,total ischemia burden(TIB)was calculated,and Gensini score was evaluated after coronary angiography.Patients were followed up for a 1-year period after discharge,and the incidence of cardiovascular adverse events was statistically analyzed.Results:With the increase of the severity of obstructive sleep apnea,the levels of Hcy,MPO,TG and Hs-CRP were significantly increased.The levels of Hcy,MPO,TG,and hs CRP in A2 group were higher than those in A1 group(P s<0.05).The levels of Hcy,MPO,TG,and hs CRP in A3 group were higher than those in A2 group(P s<0.05).As the severity of obstructive sleep apnea syndrome increases,the patient′s Gensini score and TIB show significant improvement.The Gensini score and TIB in A2 group are higher than those in A1 group(P s<0.05).The Gensini score and TIB in A3 group were higher than those in A2 group(P s<0.05).The incidence of cardiovascular adverse events in A3 group was higher than that in A2 group and A1 group(P s<0.05).Conclusion:Patients with CHD complicated with severe obstructive sleep apnea syndrome will have a serious

关 键 词：重度阻塞性睡眠呼吸暂停 冠心病 病变程度 预后 

分 类 号：R441.8[医药卫生—诊断学] R541.4[医药卫生—临床医学]