Jiao Hong-mei, Liu Mei-lin, Zhang Zhi-gang, Feng Xue-ru, Chen Yan, Li Xue-ying
Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Dec;37(12):1097-100.
To evaluate the predictive value of Holter ECG recordings for patients with moderate-severe obstructive sleep apnea and hypopnea syndrome (OSAHS).
Holter recordings was performed in 76 patients who were diagnosed OSAHS by polysomnography (PSG) within one month from Jan. 2008 to July 2009 in our hospital. Twenty-eight patients were identified as mild OSAHS (AHI < or = 20) and forty-eight patients were moderate-to-severe OSAHS (AHI > 20). The indexes of heart rate variability (HRV), total scores of thirteen sleep apnea risk indexes of Holter recordings and BMI were analyzed by bivariate Logistic regression analysis.
Clinical features (eg. Gender, age, complicated with hypertension, coronary heart disease, diabetes mellitus, hyperglycemia, and taken beta-blocker), total scores, the sum of thirteen sleep apnea risk scores collected by Holter recordings (5.64 + or - 2.33 vs. 6.42 + or - 2.22, respectively, P > 0.05) were similar between patients with mild OSAHS and moderate-to-severity OSAHS. VLF/Total Power > 70%, the difference of daytime/nighttime LF Power < -70 and BMI were independent predictors of moderate-to-severe OSAHS with OR 3.98 (1.087 - 14.596), 3.69 (1.106 - 12.285) and 1.28 (1.062 - 1.544), respectively (all P < 0.05).
VLF/Total Power and the difference of daytime/nighttime LF Power and BMI could be used as screening parameters to recognize patients with moderate-to-severe OSAHS.
评估动态心电图记录对中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的预测价值。
2008年1月至2009年7月期间,对我院76例在1个月内通过多导睡眠图(PSG)诊断为OSAHS的患者进行动态心电图记录。28例患者被确定为轻度OSAHS(呼吸暂停低通气指数[AHI]≤20),48例患者为中重度OSAHS(AHI>20)。采用双变量Logistic回归分析心率变异性(HRV)指标、动态心电图记录的13项睡眠呼吸暂停风险指数总分及体重指数(BMI)。
轻度OSAHS患者与中重度OSAHS患者的临床特征(如性别、年龄、合并高血压、冠心病、糖尿病、高血糖及服用β受体阻滞剂情况)、总分、动态心电图记录收集的13项睡眠呼吸暂停风险评分总和(分别为5.64±2.33和6.42±2.22,P>0.05)相似。极低频功率/总功率>70%、日间/夜间低频功率差值<-70及BMI是中重度OSAHS的独立预测因素,其比值比(OR)分别为3.98(1.08714.596)、3.69(1.10612.285)和1.28(1.062~1.544)(均P<0.05)。
极低频功率/总功率、日间/夜间低频功率差值及BMI可作为识别中重度OSAHS患者的筛查参数。