本文關(guān)鍵詞： 冠脈慢血流現(xiàn)象 睡眠呼吸暫停 呼吸紊亂指數(shù) 氧減指數(shù)　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]本研究通過比較阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea-hypopnea syndrome) 患者與冠脈慢血流現(xiàn)象(coronary slow flow phenomenon,CSFP)患者的一般資料、生化指標(biāo)及冠脈造影后記錄的左前降支幀數(shù)、校正左前降支(left anterior descending,LAD)幀數(shù)、左回旋支幀數(shù)、右冠脈幀數(shù)、校正后平均冠脈血流幀數(shù),睡眠監(jiān)測后的呼吸紊亂指數(shù)、最低血氧飽和度、氧減指數(shù),探討睡眠呼吸暫停與冠脈慢血流現(xiàn)象之間相關(guān)性。[方法]收集2016年1月-2017年2月入住昆明醫(yī)科大學(xué)第二附屬醫(yī)院心內(nèi)科胸痛患者146例,記錄患者一般資料,包括性別、年齡、體重、身高、BMI、腰圍、臀圍、空腹血糖(fasting blood glucose, FBG)、空腹胰島素(fasting insulin,FINS)、胰島素抵抗指數(shù)(homeostasis model insulin resistance index,HOMA-IR)、纖維蛋白原、總膽固醇(Total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白膽固醇(high density lipoprotein-cholesterol,HDL-c)、低密度脂蛋白膽固醇(Low density lipoprotein-cholesterol,LDL-c)、血小板、平均血小板體積(mean platelet volume,MPV)、C 反應(yīng)蛋白(C reactive protein,CRP)。所有患者均行冠脈造影,并記錄LAD幀數(shù)、校正LAD幀數(shù)、左回旋支幀數(shù)(left circumflex branch,LCX )、右冠脈(Right coronary branch , RCA)幀數(shù)、平均冠脈血流幀數(shù)(mean TIMI frame counts,mean TFC),分為冠脈慢血流組和非冠脈慢血流組。非冠脈慢血流組為隨機(jī)選取同期冠脈造影患者。再行多導(dǎo)睡眠監(jiān)測,記錄AHI、ODI、LSPO2,比較冠脈慢血流組和非冠脈慢血流組的OSAHS發(fā)病率。再將冠脈慢血流患者分為OSAHS組和非OSAHS組,統(tǒng)計分析闡明冠脈慢血流與OSAHS的關(guān)系。計量資料符合正態(tài)分布采用均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,兩組間差異分析用t檢驗。計數(shù)資料用率或構(gòu)成比表示,如性別、高血壓、糖尿病,吸煙兩組間差異采用卡方檢驗。采用多因素Logistic回歸分析冠脈慢血流的危險因素。[結(jié)果]1.冠脈慢血流組OSAHS發(fā)病率較非冠脈慢血流組高(45.8% : 14% )。2. OSAHS 組患者的 LCX 幀數(shù)(30.45±4.92)、RCA 幀數(shù)(38.88±2.10)、mean TFC(30.85 ±1.90)較非 OSAHS 組高(21. 31±2. 6, 35. 42±6.18 ,25.15±1.18 )(P0.05)。3.以AHI、LSAO2、ODI為自變量,mean TFC為因變量,進(jìn)行逐步回歸分析,發(fā)現(xiàn) AHI (r=0.87, p0.01)、ODI (r=0.851,p0.01)與 mean TFC成正相關(guān),LSAO2與mean TFC成負(fù)相關(guān)(r=-0.82,p0.01)。[結(jié)論]冠脈慢血流現(xiàn)象與AHI、ODI呈顯著正相關(guān),與LSA02呈顯著負(fù)相關(guān),OSAHS促進(jìn)了冠脈慢血流現(xiàn)象的發(fā)生與發(fā)展。
[Abstract]:[objective] to compare the general data, biochemical indexes and the number of frames of left anterior descending branch in patients with obstructive sleep apnea-hypopnea syndrome and coronary slow flow phenomenon flow in patients with obstructive sleep apnea hypopnea syndrome (OSAS). The number of left anterior descending lad frames, the left circumflex branch frames, the right coronary artery frames, the average coronary blood flow frame number, the respiratory disturbance index after sleep monitoring, the lowest oxygen saturation, the oxygen desaturation index, the left anterior descending branch frame number, the right coronary artery frame number, the sleep monitoring respiratory disturbance index, the lowest oxygen saturation, the oxygen desaturation index, To investigate the correlation between sleep apnea and slow coronary flow. [methods] A total of 146 patients with chest pain in Department of Cardiology, second affiliated Hospital of Kunming Medical University, from January 2016 to February 2017, were collected and their general data, including sex and age, were recorded. Weight, height, waist circumference, hip circumference, fasting blood glucose, FBG, fasting insulin, fasting insulin, insulin resistance index, homeostasis model insulin resistance index-HOMA-IRN, fibrinogen. Total cholesterol cholesterol total cholesterol total cholesterol, triglyceride triglyceride, high density lipoprotein cholesterol high density protein-cholesterol HDL-cn, low density lipoprotein cholesterol low density protein-cholesterol, platelet, mean platelet volume, MPVV-C-reactive protein C reactive protein, all patients underwent coronary angiography and recorded LAD frames, Corrected LAD frames, left circumflex branchs, right coronary branches, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs. The mean TIMI frame count was divided into two groups: slow coronary flow group and non-coronary slow flow group. The non-coronary slow flow group was randomly selected for simultaneous coronary angiography, and polysomnography was performed. The incidence of OSAHS was compared between slow coronary flow group and non-coronary slow flow group. Patients with slow coronary flow were divided into OSAHS group and non-#en2# group. Statistical analysis was used to clarify the relationship between coronary slow flow and OSAHS. The mean 鹵standard deviation x 鹵s was used to measure the normal distribution, and t test was used to analyze the difference between the two groups. The rate or composition ratio of the counting data, such as sex, hypertension, diabetes mellitus, were used to calculate the difference between the two groups, such as sex, hypertension, diabetes mellitus. Smoking difference between the two groups was chi-square test. Multivariate Logistic regression analysis was used to analyze the risk factors of coronary slow flow. [results] 1. The incidence of OSAHS in the slow coronary flow group was 45.8% higher than that in the non-coronary slow flow group. The LCX frame number of the patients in the OSAHS group was higher than that in the non-coronary slow flow group. The mean TFC(30.85 鹵1.90 (38.88 鹵2.10 TFC(30.85 鹵1.90) was higher than that in the non-#en1# group (21.31 鹵2.6,3542 鹵6.18 鹵25.15 鹵1.18). By stepwise regression analysis, it was found that there was a positive correlation between AHI TFC and mean TFC. [conclusion] there was a significant positive correlation between slow coronary flow and mean TFC. [conclusion] there was a significant positive correlation between slow coronary flow and mean TFC, and there was a negative correlation between LSAO 2 and mean TFC. [conclusion] there is a significant positive correlation between slow coronary flow and mean TFC, and the correlation between LSAO 2 and mean TFC is negative. [conclusion] there is a significant positive correlation between coronary slow flow and mean TFC. There was a significant negative correlation with LSA02. OSAHS promoted the occurrence and development of slow coronary flow.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R766;R541.4

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