發(fā)布時(shí)間：2019-04-29 18:13

【摘要】：目的:應(yīng)用便攜式多導(dǎo)睡眠監(jiān)測(cè)儀(PSG)監(jiān)測(cè)邊遠(yuǎn)地區(qū)慢性心力衰竭患者,分析其中睡眠呼吸暫停特別是中樞性睡眠呼吸暫停的臨床意義。方法:選擇云南省怒江傈僳族自治州人民醫(yī)院心血管病內(nèi)科住院的患者40例,應(yīng)用PSG監(jiān)測(cè)其中瓣膜性心臟病患者16例,其他病因引起的心臟擴(kuò)大患者24例。根據(jù)呼吸暫停低通氣指數(shù)(AHI)分為兩組,即AHI≥5次/h組20例和AHI5次/h組20例,分析比較兩組患者中樞性睡眠呼吸暫停與心功能的關(guān)系。結(jié)果:(1)AHI≥5次/h組患者美國(guó)紐約心臟協(xié)會(huì)(NYHA)心功能Ⅲ/Ⅳ級(jí)比例、左心房?jī)?nèi)徑、左心室舒張末期內(nèi)徑、左心室收縮末期內(nèi)徑、左心室舒張末期容積、左心室收縮末期容積、AHI以及氧減指數(shù)均明顯大于AHI5次/h組,而左心室射血分?jǐn)?shù)低于AHI5次/h組,差異均有統(tǒng)計(jì)學(xué)意義(P均0.05)。(2)AHI≥5次/h組20例患者中以中樞性睡眠呼吸暫停為主16例,以阻塞性睡眠呼吸暫停為主4例。(3)多元Logistic向前逐步選擇(Wald)回歸分析結(jié)果表明,AHI≥5次/h與左心室射血分?jǐn)?shù)[優(yōu)勢(shì)比(OR)=0.9,95%可信區(qū)間(CI):0.8~1.0,P=0.017)]、最低氧飽和度(OR=0.9,95%CI:0.7~1.0,P=0.022)以及左心室后壁厚度(OR=0.3,95%CI:0.1~0.9,P=0.034)相關(guān);中樞性睡眠呼吸暫停與NYHA心功能Ⅲ/Ⅳ級(jí)相關(guān)(OR=15.0,95%CI:3.2~71.4,P=0.001)。結(jié)論:睡眠呼吸暫停尤其中樞性睡眠呼吸暫停是嚴(yán)重慢性心力衰竭的一種表現(xiàn),PSG應(yīng)用于邊遠(yuǎn)地區(qū)慢性心力衰竭患者的評(píng)估及治療隨訪,具有現(xiàn)實(shí)意義。
[Abstract]:Aim: to monitor chronic heart failure patients in remote areas by portable polysomnography (PSG), and to analyze the clinical significance of sleep apnea, especially central sleep apnea. Methods: forty patients in the Department of Cardiovascular Diseases of Nujiang Lisu Autonomous Prefecture people's Hospital in Yunnan Province were selected. PSG was used to monitor 16 patients with valvular heart disease and 24 patients with heart enlargement caused by other causes. According to the apnea hypopnea index (AHI), the patients were divided into two groups: AHI 鈮，

本文編號(hào)：2468422