睡眠呼吸紊乱与冠心病的临床研究  

Sleep-disordered breathing and coronary artery disease: a clinical research

作　　者：张文莉[1] 王士雯[1] 卢才义[1] 刘鹏[1] 陈瑞[1] 季鲜[1] 赵玉生[1] 

机构地区：[1]北京解放军总医院老年心血管病研究所,100853

出　　处：《中华老年多器官疾病杂志》2003年第2期119-122,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：军队"十五"重点课题(编号02Z009)

摘　　要：目的 了解在经冠状动脉造影证实的冠心病患者中睡眠呼吸紊乱的发生情况,并探讨睡眠呼吸紊乱与心肌梗死之间的关系。方法 对94例经冠状动脉造影证实的男性冠心病患者及28例排除了冠心病的男性患者在睡眠实验室进行了整夜的多导睡眠监测,回归分析评估危险因素与冠心病的相关性。结果 52.1％的冠心病患者并发睡眠呼吸紊乱;对照组有21.4％并发睡眠呼吸紊乱(P<0.05)。冠心病患者平均呼吸紊乱指数(RDI)显著高于对照组(P<0.05)。冠心病合并睡眠呼吸紊乱患者的体重指数显著高于单纯冠心病患者(P<0.01)。两组患者左室射血分数及其他危险因素之间相比无明显不同。睡眠呼吸紊乱的存在与冠状动脉疾病独立相关(OR2.4,P<0.05),中度以上的睡眠呼吸紊乱与心肌梗死独立相关(OR2.1,P<0.05)。结论 经冠状动脉造影证实的冠心病患者中睡眠呼吸紊乱的发生率较高。睡眠呼吸紊乱是冠状动脉疾病的独立危险因素,中度以上(RDI≥20)的睡眠呼吸紊乱是心肌梗死的重要预测因素。因此,对于冠心病患者,提高对睡眠呼吸紊乱的警惕性是非常重要的。Objective To assess the prevalence of sleep-disordered breathing in patients with coronary artery disease (CAD) verified angiographically, and to analyze the relationship between sleep-disordered breathing and myocardial infarction. Methods The whole-night sleep monitoring was performed in the sleep laboratory for 94 male patients with angiographically verified CAD and 28 male patients without CAD. A regression analysis was performed to assess the correlation between risk factors and CAD. Results CAD patients were found to have sleep-disordered breathing in 52.1 % , whereas sleep-disordered breathing was found in 21.4% of control subjects (P<0.05). The mean respiratory disturbance index (RDI) was significantly higher(P<0.05) in CAD patients than in control subjects. Body mass index (BMI) was significantly higher in patients with CAD and sleep-disordered breathing than in patients with CAD without sleep-disorder ed breathing( P < 0.01). No significant difference was found with regard to left ventricular ejection fraction (LVEF) and other risk factors between the two groups. The existence of sleep-disordered breathing was independently associated with coronary artery disease (OR 2. 4, P < 0.05). Sleep-disordered breathing with RDI>20 (OR 2.1, P < 0.05) was independently associated with myocardial infarction. Conclusions There is a high prevalence of sleep-disordered breathing among patients with angiographically proven CAD. Sleep-disordered breathing is an independent risk factor of coronary artery disease. Sleep-disordered breathing of moderate severity (RDI≥20) is an important predictor of myocardial infarction. Thus, for patients with CAD, particular vigilance for sleep-disordered breathing is important.

关 键 词：睡眠呼吸紊乱 冠心病 临床研究 危险因素 流行病学 

分 类 号：R541.4[医药卫生—心血管疾病] R563.8[医药卫生—内科学]