本文選題：睡眠呼吸暫停綜合征　切入點(diǎn)：心房顫動　出處：《南京醫(yī)科大學(xué)》2016年博士論文　論文類型：學(xué)位論文

【摘要】：背景和目的心力衰竭、睡眠呼吸障礙疾病和心律失常之間的關(guān)系復(fù)雜,而且關(guān)于這方面的報道不多。本研究分析心衰合并心房顫動(房顫)患者睡眠呼吸暫停綜合征(SAS)的發(fā)生情況及臨床特征。材料和方法對2012年6月至2014年6月期間在南京醫(yī)科大學(xué)第一附屬醫(yī)院住院的心衰患者進(jìn)行心電圖篩選出110例房顫患者(合并房顫組),同時將年齡、性別、體質(zhì)指數(shù)相匹配的105例無房顫的單純心衰患者(單純心衰組)作為平行對照,對比觀察及分析兩組患者SAS的發(fā)病情況及特征。結(jié)果兩組在心衰病因、合并癥、NYHA分級、基礎(chǔ)用藥方面差異均無統(tǒng)計(jì)學(xué)意義。合并房顫組白日Epworth嗜睡量表評分和心胸比均顯著高于單純心衰組[(10.1±5.8)比(8.2±5.5)分和0.63±0.08比0.57±0.07,均P0.05],而6 min步行距離顯著短于單純心衰組[(305+70)比(335+69)m,P0.05]。兩組患者左室射血分?jǐn)?shù)、左室舒張末內(nèi)徑、左室收縮末內(nèi)徑差異均無統(tǒng)計(jì)學(xué)意義,而合并房顫組左房內(nèi)徑顯著大于單純心衰組(P0.05)。合并房顫組SAS發(fā)生比例顯著高于單純心衰組(36.4%比20.0%,P0.05),睡眠呼吸暫停低通氣指數(shù)也顯著高于單純心衰組[4(1,16)比3(1,7)次/h,P0.05],而其他多導(dǎo)睡眠監(jiān)測指標(biāo)如快動眼睡眠時間百分比、覺醒指數(shù)、平均氧飽和度、最低氧飽和度、氧減指數(shù)等差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論心衰合并房顫患者比單純心衰患者更易發(fā)生SAS,以CSA為主,且白日嗜睡更重,活動能力更差。
[Abstract]:Background and objective the relationship between heart failure, sleep apnea and arrhythmia is complex. In this study, the incidence and clinical characteristics of sleep apnea syndrome (SAS) in patients with heart failure complicated with atrial fibrillation (AF) were analyzed. Materials and methods from June 2012 to June 2014. In the first affiliated Hospital of Nanjing Medical University, 110 patients with atrial fibrillation were selected by electrocardiogram. Sex and body mass index matched 105 patients with simple heart failure without atrial fibrillation (simple heart failure group) as parallel control. The incidence and characteristics of SAS in the two groups were compared and analyzed. The scores of daytime Epworth somnolence scale and cardiothoracic ratio in patients with atrial fibrillation were significantly higher than those in patients with simple heart failure [10.1 鹵5.8 vs 8.2 鹵5.5, 0.63 鹵0.08 vs 0.57 鹵0.07, P0.05, respectively], but the walking distance of 6 min was significantly shorter than that of simple heart failure group. [P 0.05]. Left ventricular ejection fraction (LVEF) in both groups, There was no significant difference in left ventricular end-diastolic diameter and left ventricular end-systolic diameter. The incidence of SAS in the group with AF was significantly higher than that in the group with simple heart failure (36.4% vs 20.0%, P 0.05), and the sleep apnea hypopnea index was significantly higher than that in the group with simple heart failure (P < 0.05), but the incidence of SAS was significantly higher than that in the group with simple heart failure (P < 0.05), but the incidence of SAS was significantly higher than that in the group with atrial fibrillation (P < 0.05), and the sleep apnea hypopnea index was significantly higher than that in the group with simple heart failure (P < 0.05). His polysomnography monitoring indicators such as the percentage of fast eye movement sleep time, There was no significant difference in arousal index, mean oxygen saturation, minimum oxygen saturation and oxygen reduction index (all P 0.05). Conclusion patients with heart failure complicated with atrial fibrillation are more likely to develop sass than those with simple heart failure, CSA is the main factor, and daytime sleepiness is more severe. The activity ability is worse.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R541;R766

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