Saito T, Yoshikawa T, Sakamoto Y, Tanaka K, Inoue T, Ogawa R
Department of Coronary Care Medicine and Anesthesiology, Nippon Medical School, Tokyo, Japan.
Crit Care Med. 1991 Jul;19(7):938-41. doi: 10.1097/00003246-199107000-00019.
To document sleep apnea in the acute phase of myocardial infarction. If apnea occurs in patients with myocardial infarction, hypoxemia induced by apnea might exaggerate insufficiency of oxygen supplied to the damaged myocardium.
Prospective controlled study.
Critical care unit of a teaching hospital.
Forty-nine patients, average age 64 yrs (range 49 to 91).
Patient measurements were recorded on a polygraph using an apnea-monitor, pulse oximeter, pulmonary artery pressure monitor, and an ECG. All of the patients observed showed frequent apneic episodes. The apnea was especially frequent when the cardiac index was low. Capillary oxygen saturation of less than 90% (suggesting systemic hypoxia) was observed in 21 patients concomitantly with apnea. Occasionally, arrhythmias followed these episodes (premature supraventricular contractions [n = 10], premature ventricular contraction [n = 4], and ventricular tachycardia [n = 2]).
This study suggests that sleep apnea is common in the setting of acute myocardial infarction. It may be a factor predisposing to, or even causing, sudden death in patients with acute phase of myocardial infarction.
记录心肌梗死急性期的睡眠呼吸暂停情况。如果心肌梗死患者发生呼吸暂停，呼吸暂停所致的低氧血症可能会加重受损心肌的供氧不足。
前瞻性对照研究。
一家教学医院的重症监护病房。
49例患者，平均年龄64岁（范围49至91岁）。
使用呼吸暂停监测仪、脉搏血氧饱和度仪、肺动脉压力监测仪和心电图仪在多导睡眠图上记录患者的测量数据。所有观察到的患者均出现频繁的呼吸暂停发作。当心脏指数较低时，呼吸暂停尤为频繁。21例患者在呼吸暂停时同时出现毛细血管血氧饱和度低于90%（提示全身性缺氧）。偶尔，这些发作后会出现心律失常（室上性早搏[n = 10]、室性早搏[n = 4]和室性心动过速[n = 2]）。
本研究表明，睡眠呼吸暂停在急性心肌梗死患者中很常见。它可能是急性心肌梗死患者猝死的一个诱发因素，甚至可能是导致猝死的原因。
