本文選題：睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：阻塞性　出處：《福建醫(yī)科大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析阻塞性睡眠呼吸暫停低通氣綜合征( Obstructive sleep apnea-hypopnea syndrome,OSAHS)患者心律失常發(fā)生情況,探討OSAHS相關(guān)心律失常的可能機(jī)制。 方法:收集2010年2月至2011年5月就診于福建省立醫(yī)院主訴睡眠打鼾的87例門診和住院患者病史資料,同步進(jìn)行整夜多導(dǎo)睡眠圖(polysomnography,PSG)和24小時(shí)動(dòng)態(tài)心電圖監(jiān)測(cè)。根據(jù)睡眠監(jiān)測(cè)結(jié)果分兩組:OSAHS組共55例(apnea hypopnea index ,AHI"g5)對(duì)照組為單純鼾癥組共32例(AHI5)。其中,OSAHS組按AHI值再分為:輕度OSAHS(5≤AHI≤20)13例,中度OSAHS(21≤AHI≤40)16例;重度OSAHS (AHI40)26例。比較兩組睡眠呼吸紊亂情況,比較不同程度OSAHS患者心律失常的發(fā)生率、心律失常類型,采用心率變異性分析評(píng)價(jià)OSAHS患者自主神經(jīng)功能變化,探討OSAHS患者心律失常的可能機(jī)制。 結(jié)果:1.本研究中OSAHS組絕大多數(shù)為中年男性患者,體重指數(shù)、上氣道解剖異常的比例較單純鼾癥組增加(p 0.05),嗜睡程度(Epworth sleepiness scale, ESS評(píng)分)較單純鼾癥組加重(p 0.05);2. OSAHS組呼吸紊亂次數(shù)(AHI)較單純鼾癥組明顯增高,低氧的程度(LSPO_2、ASPO_2均下降)較單純鼾癥組嚴(yán)重,低氧的持續(xù)時(shí)間(LAT、AAT、PSPO_290、TSPO_290均增加)較單純鼾癥組延長(zhǎng)(p 0.05);3.OSAHS組睡眠覺醒指數(shù)增加,睡眠N3期比例下降(p 0.05)。4. OSAHS患者心律失常的發(fā)生率為54.6%。快速性心律失常以偶發(fā)室上性早搏(47.3%)和室性早搏(23.6%)最常見;緩慢性心律失常如心動(dòng)過緩、房室傳導(dǎo)阻滯、竇性停搏、逸搏心律多見于重度OSAHS患者;14.5%OSAHS患者出現(xiàn)聯(lián)合心律失常。5.OSAHS組夜間TP、VLF、LF、HF均較單純鼾癥組高(p 0.05),全天的平均心率高于單純鼾癥組(p 0.05)。 結(jié)論:1. OSAHS患者夜間有明顯低氧血癥,睡眠中覺醒增加,深睡眠比例下降。OSAHS患者夜間交感、副交感神經(jīng)調(diào)控作用均增加,并以交感神經(jīng)調(diào)控作用增加占優(yōu)勢(shì)。2.OSAHS患者心律失常發(fā)生率為54.6%。心律失常的類型以室上性和室性早搏最常見。而緩慢性心律失常多見于重度OSAHS患者。隨著OSAHS病情的加重,心律失常的復(fù)雜及嚴(yán)重程度增加。3.OSAHS相關(guān)的心律失常可能與低氧和自主神經(jīng)功能紊亂有關(guān)。
[Abstract]:Objective: to analyze the incidence of arrhythmias in patients with Obstructive sleep apnea-hypopnea syndrome (OSAHS) and to explore the possible mechanism of OSAHS related arrhythmias. Methods: from February 2010 to May 2011, 87 outpatients and inpatients with sleep snoring who were admitted to Fujian Provincial Hospital were collected. The polysomnography (PSG) and 24 hour ambulatory electrocardiogram (ECG) were performed simultaneously. According to the results of sleep monitoring, 55 cases of hypopnea index AHI "g5" were divided into two groups. The control group consisted of 32 patients with simple snoring. According to the AHI value, OSAHS group was subdivided into two groups: mild OSAHS(5 鈮，

本文編號(hào)：1596860