本文關(guān)鍵詞：阻塞性睡眠呼吸暫停低通氣綜合征患者冠狀動(dòng)脈病變特點(diǎn)及其影響因素研究　出處：《中國(guó)全科醫(yī)學(xué)》2014年33期 　論文類型：期刊論文

  更多相關(guān)文章： 冠狀動(dòng)脈疾病 睡眠呼吸暫停 阻塞性 危險(xiǎn)因素

【摘要】：目的分析阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者冠狀動(dòng)脈病變特點(diǎn)及其影響因素。方法選取2013年6月—2014年6月在新疆醫(yī)科大學(xué)第一附屬醫(yī)院心臟中心住院完善睡眠呼吸監(jiān)測(cè)并行冠狀動(dòng)脈造影的患者120例,根據(jù)呼吸暫停低通氣指數(shù)(AHI)將患者分為對(duì)照組(AHI10次/h)25例,輕度組(AHI 10~15次/h)32例,中重度組(AHI15次/h)63例。收集患者一般資料,如性別、年齡、吸煙史、飲酒史、高血壓、糖尿病檢出率,并測(cè)定三酰甘油(TG)、總膽固醇(TC)、空腹血糖(FBG)水平。對(duì)患者進(jìn)行睡眠呼吸監(jiān)測(cè),記錄最低血氧飽和度(LSaO2);并進(jìn)行冠狀動(dòng)脈造影,對(duì)冠狀動(dòng)脈的主要血管左主干(LM)、左前降支(LAD)、左回旋支(LCX)、右冠狀動(dòng)脈(RCA)進(jìn)行評(píng)價(jià),將其中任意1支血管內(nèi)徑狹窄≥50%診斷為冠心病。根據(jù)累及的主要冠狀動(dòng)脈支數(shù),診斷為單支病變及多支病變(病變累及2支動(dòng)脈及以上者,定義為多支病變)。采用多因素Logistic回歸分析影響OSAHS患者合并冠心病、單支病變及多支病變的因素。結(jié)果對(duì)照組、輕度組和中重度組性別、吸煙率、飲酒率、體質(zhì)指數(shù)(BMI)、TG、TC、24 h平均收縮壓(24 hSBP)、24 h平均舒張壓(24 hDBP)比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3組年齡比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中中重度組年齡高于輕度組(P0.05)。3組LM、LCX、多支病變發(fā)生率比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);3組LSaO2及LAD、RCA、單支病變、冠心病發(fā)生率比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),其中中重度組LSaO2均低于對(duì)照組和輕度組(P0.05),LAD、RCA、單支病變、冠心病發(fā)生率均高于對(duì)照組和輕度組(P0.01)。以冠心病、單支病變、多支病變?yōu)橐蜃兞?以性別、吸煙、飲酒、年齡、高血壓、糖尿病、AHI、LSaO2為自變量,Logistic回歸分析結(jié)果顯示,飲酒、年齡、AHI與OSAHS患者合并冠心病有回歸關(guān)系(P0.05);飲酒、AHI與OSAHS患者合并單支病變有回歸關(guān)系(P0.05);年齡與OSAHS患者合并多支病變有回歸關(guān)系(P0.05)。結(jié)論隨著OSAHS患者病情加重,發(fā)生冠心病的可能性增加,主要表現(xiàn)為發(fā)生單支病變,其中LAD及RCA為最易受累血管。飲酒、年齡、AHI為OSAHS患者合并冠心病的危險(xiǎn)因素;飲酒、AHI為OSAHS患者合并單支病變的危險(xiǎn)因素;年齡為OSAHA患者合并多支病變的危險(xiǎn)因素。
[Abstract]:Objective to analyze obstructive sleep apnea hypopnea syndrome (OSAHS). Methods from June 2013 to June 2014, the patients were hospitalized in the heart center of the first affiliated Hospital of Xinjiang Medical University and underwent complete sleep breathing monitoring and coronary arteriostomy. There were 120 cases of shadow. According to apnea hypopnea index (AHII), the patients were divided into control group (n = 25), control group (n = 25) and mild group (n = 32). Data of 63 patients with AHI 15 / h were collected, such as sex, age, smoking history, alcohol consumption history, hypertension, diabetes mellitus detection rate, and triglyceride triglyceride (TG). Total cholesterol (TC), fasting blood glucose (FBG) were monitored by sleep respiration, and the lowest oxygen saturation was recorded. Coronary arteriography was performed to evaluate the left main artery of the coronary artery (LMN), left anterior descending branch (LADV), left circumflex branch (LCX), and right coronary artery (RCA). Any one vessel stenosis 鈮，

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