阻塞性睡眠呼吸暂停患者的 P 波持续时间和离散度。
P-wave duration and dispersion in patients with obstructive sleep apnea.
出版信息
Int J Cardiol. 2009 Apr 17;133(3):e85-9. doi: 10.1016/j.ijcard.2007.11.037. Epub 2008 Jan 14.
AIM
P-wave dispersion (Pd) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The purpose of this study was to investigate Pd in patients with obstructive sleep apnea (OSA) and to determine its relationship with severity of the disease.
METHODS
The study population included 67 patients referred to sleep laboratory. The Apnea-Hypopnea Index (AHI) was defined as the number of apneas and hypopneas per hour of sleep. Of the sixty-seven patients, 48 had AHI5 and were diagnosed as OSA. Nineteen of the patients had AHI<5 and were diagnosed as OSA (-) (Group 1), 32 of the patients had AHI between 5-30 (mild and moderate, group 2), 16 of the patients had AHI>30 (severe, group 3). The P-wave duration was calculated in all leads of the surface electrocardiogram. The difference between the maximum (Pmax) and minimum P (Pmin) wave duration was calculated and was defined as the P-wave dispersion (Pd). Echocardiographic examination was also performed.
RESULTS
Pmax was longer in group 3 compared to group 2 and group 1 (p=0.002, p<0.001 respectively). Pmax was longer in group 2 compared to group 1 (s<0.001). Pd was greater in group 3 compared to group 2 and group 1 (p<0.001 for both comparison). Pd was greater in group 2 compared to group 1 (p<0.001). Pmin did not differ between the groups. In patients with OSA, Pd was positively correlated with AHI (r=0.56, p<0.001), BMI (r=0.43, p=0.03), and mitral early diastolic to late diastolic velocity (E/A) ratio (r=0.37, p=0.01). Multiple linear regression analysis showed that only AHI was independently associated with Pd (beta=0.39, p=0.02).
CONCLUSION
Pd was found to be greater in patients with OSA than patients without OSA and to be associated with severity of the disease.
目的
已有研究表明，P 波离散度（Pd）与窦房结冲动不均匀和不连续传播有关。本研究旨在探讨阻塞性睡眠呼吸暂停（OSA）患者的 Pd，并确定其与疾病严重程度的关系。
方法
研究人群包括 67 名被转介至睡眠实验室的患者。呼吸暂停低通气指数（AHI）定义为每小时睡眠中呼吸暂停和低通气的次数。在这 67 名患者中，48 名 AHI5，被诊断为 OSA。19 名患者 AHI<5，被诊断为 OSA（-）（组 1），32 名患者 AHI 在 5-30 之间（轻度和中度，组 2），16 名患者 AHI>30（重度，组 3）。在体表心电图的所有导联中计算 P 波持续时间。计算最大（Pmax）和最小 P 波（Pmin）之间的差异，并定义为 P 波离散度（Pd）。还进行了超声心动图检查。
结果
与组 2 和组 1 相比，组 3 的 Pmax 更长（p=0.002，p<0.001）。与组 1 相比，组 2 的 Pmax 更长（s<0.001）。与组 2 和组 1 相比，组 3 的 Pd 更大（两者比较均 p<0.001）。与组 1 相比，组 2 的 Pd 更大（p<0.001）。各组间 Pmin 无差异。在 OSA 患者中，Pd 与 AHI（r=0.56，p<0.001）、BMI（r=0.43，p=0.03）和二尖瓣早期舒张晚期舒张速度（E/A）比值（r=0.37，p=0.01）呈正相关。多元线性回归分析显示，只有 AHI 与 Pd 独立相关（beta=0.39，p=0.02）。
结论
与无 OSA 患者相比，OSA 患者的 Pd 更大，且与疾病严重程度相关。
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