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目的:观察冠心病(CHD)患者中阻塞性睡眠呼吸暂停综合征(OSAS)的患病率,探讨OSAS与CHD的关系。方法:83例可疑CHD的患者行冠状动脉造影,依据造影结果分为CHD组(48例),冠状动脉造影阴性组(35例),83例患者均行多导睡眠仪(PSG)监测,依据PSG监测得出的睡眠呼吸暂停低通气指数(AHI)分为轻度OSAS组(10≤AHI<20,23例)、中重度OSAS组(AHI≥20,21例)和非OSAS组(对照组,AHI<10,39例)。3组均计算Gensini评分,用于评估冠状动脉粥样硬化病变的程度。用Logistic回归评估OSAS以及其他危险对CHD的影响。结果:CHD组中OSAS的患病率高于冠状动脉造影阴性组。轻度和中重度OSAS组,最低血氧饱和度低于对照组;CHD患病率高于对照组;冠状动脉病变单支受累百分率显著高于对照组,多支受累百分率高于对照组;中重度OSAS组的Gensini评分显著高于对照组。多因素Logistic回归得出OSAS、高血压以及脂蛋白(a)与CHD独立相关。结论:在冠状动脉造影证实的CHD患者中OSAS患病率较高,多因素回归发现OSAS与CHD独立相关,OSAS可能是导致冠心病的一个重要的独立危险因素。
Objective: To observe the prevalence of obstructive sleep apnea syndrome (OSAS) in patients with coronary heart disease (CHD) and to explore the relationship between OSAS and CHD. Methods: Eighty-three patients with suspected CHD underwent coronary angiography and were divided into CHD group (n = 48) and coronary angiography negative group (n = 35) according to the angiographic results. All 83 patients underwent polysomnography (PSG) PSG monitoring of apnea hypopnea index (AHI) was divided into mild OSAS group (10≤AHI <20,23), moderate and severe OSAS group (AHI≥20,21) and non-OSAS group (control group , AHI <10,39). The Gensini score was calculated in all 3 groups to assess the extent of coronary atherosclerotic lesions. Logistic regression was used to assess the effect of OSAS and other risks on CHD. Results: The prevalence of OSAS in CHD group was higher than that in coronary angiography group. In mild and moderate OSAS group, the lowest oxygen saturation was lower than that of the control group. The prevalence of CHD was higher than that of the control group. The single coronary artery lesion involvement percentage was significantly higher than that of the control group, and the multiple branch involvement percentage was higher than that of the control group. The Gensini score of severe OSAS group was significantly higher than that of control group. Multivariate Logistic regression showed that OSAS, hypertension, and lipoprotein (a) were independently associated with CHD. Conclusion: The prevalence of OSAS is high in CHD patients confirmed by coronary angiography. Multivariate regression analysis showed that OSAS was independently associated with CHD. OSAS may be an important independent risk factor for coronary heart disease.