阻塞性睡眠呼吸暂停低通气综合征与冠状动脉粥样硬化及冠心病相关性的研究

[A study on the association of obstructive sleep apnea hypopnea syndrome with coronary atherosclerosis and coronary heart disease].

作者信息

Lu Gan, Xu Zhuo-wen, Liu Jian-nan, Zhang Yu-lin, Yang Zhi-jian, Zhang Xi-long, Yin Kai-sheng

机构信息

Department of Pulmonary Medicine, Gerontology Research Institution of Jiangsu Province, Nanjing 210024, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2007 Mar;30(3):178-81.

PMID:17572995

Abstract

OBJECTIVE

To investigate the association of obstructive sleep apnea hypopnea syndrome (OSAHS) with coronary atherosclerotic disease (CAD).

METHODS

From March of 2005 to December of 2005, 82 subjects admitted into Department of Cardiology of The First Affiliated Hospital of Nanjing Medical University were recruited. They were divided into three groups based on their nocturnal apnea hypopnea index (AHI) detected by examination of polysomnography (PSG): mild OSAHS group (5 < AHI < or = 20, 38 cases), moderate-to-severe group (AHI > 20, 20 cases) and control group (AHI < 5, 24 cases). Coronary artery angiography and Gensini Score for assessing the severity of coronary atherosclerosis were performed in all three groups.

RESULTS

Compared with the control group, the apnea-hypopnea index (AHI) was significantly higher in OSAHS groups [10.9 (7.7 - 15.2), 29.3 (23.3 - 48.4) vs 2.9 (1.9 - 3.8)]. The minimal SpO(2) was significantly lower (84 +/- 9)%, (81 +/- 9)% in OSAHS groups than that in the control group (89 +/- 6)%. The incidence of CAD was significantly higher [66% (25/38) and 95% (19/20)] in OSAHS groups than in the control group [17% (4/24)]. The percentage of patients with single-coronary-vessel disease was 24% (9/38) in mild OSAHS group, 20% (4/20) in moderate-to-severe OSAHS group, and 17% (4/24) in control group. The patients with multi-coronary-vessel disease were 42% (16/38) in mild OSAHS group, 80% (16/20) in moderate-to-severe OSAHS group, and 12.5% (3/24) in control group. Gensini Score was significantly higher in moderate-to-severe OSAHS group than that in control group [35.0 (16.5 - 87.0), 1.0 (0.0 - 5.0)]. Moreover, a positive correlation was revealed between AHI and Gensini Score.

CONCLUSION

OSAHS may be a significant independent risk factor of coronary atherosclerosis and CAD and should be taken into account in CAD secondary prevention.

摘要

目的

探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与冠状动脉粥样硬化性心脏病（CAD）之间的关联。

方法

选取2005年3月至2005年12月在南京医科大学第一附属医院心内科住院的82例患者。根据多导睡眠图（PSG）检查所测夜间呼吸暂停低通气指数（AHI）将其分为三组：轻度OSAHS组（5＜AHI≤20，38例）、中重度组（AHI＞20，20例）和对照组（AHI＜5，24例）。对三组患者均进行冠状动脉造影及采用Gensini评分评估冠状动脉粥样硬化的严重程度。

结果

与对照组相比，OSAHS组的呼吸暂停低通气指数（AHI）显著更高[分别为10.9（7.7 - 15.2）、29.3（23.3 - 48.4），而对照组为2.9（1.9 - 3.8）]。OSAHS组的最低血氧饱和度（SpO₂）显著更低，分别为（84±9）%、（81±9）%，而对照组为（89±6）%。OSAHS组CAD的发生率显著高于对照组[分别为66%（25/38）和95%（19/20），对照组为17%（4/24）]。轻度OSAHS组单支冠状动脉病变患者的比例为24%（9/38），中重度OSAHS组为20%（4/20），对照组为17%（4/24）。轻度OSAHS组多支冠状动脉病变患者的比例为42%（16/38），中重度OSAHS组为80%（16/20），对照组为12.5%（3/24）。中重度OSAHS组的Gensini评分显著高于对照组[分别为35.0（16.5 - 87.0），对照组为1.0（0.0 - 5.0）]。此外，AHI与Gensini评分之间呈正相关。