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亚洲阻塞性睡眠呼吸暂停患者心律失常的患病率:新加坡睡眠中心的经验。

Prevalence of Cardiac Arrhythmias in Asian Patients With Obstructive Sleep Apnea: A Singapore Sleep Center Experience.

机构信息

Department of Otolaryngology, Singapore General Hospital, Singapore.

Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore.

出版信息

J Clin Sleep Med. 2017 Nov 15;13(11):1265-1271. doi: 10.5664/jcsm.6794.

Abstract

STUDY OBJECTIVES

Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Cardiac arrhythmias are common in patients with OSA. However, the prevalence and significance of cardiac arrhythmias in Asian patients with OSA are not well studied. The aim of this study is to determine the prevalence of cardiac arrhythmias in patients with OSA in Singapore and to evaluate possible factors that may predispose patients with OSA to arrhythmias.

METHODS

A retrospective study of 2,019 patients was carried out from January 2011 to December 2012 at a sleep center in a tertiary medical center. Of the population, 1,457 patients were found to have OSA and 144 patients were found to have cardiac arrhythmias. Data collected included patient demographics, comorbidities, and polysomnogram parameters.

RESULTS

The prevalence of cardiac arrhythmias in our OSA population is 8.0%, compared to that of primary snorers at 4.8% ( = .015). The univariate analysis revealed that older age, higher body mass index, comorbidities, and severity of OSA, including apnea-hypopnea index (AHI), lowest oxygen saturation (LSAT) and hypoxic time were correlated with a higher prevalence of cardiac arrhythmias ( < .05). However, the multivariate analysis showed that only age and body mass index were significantly correlated with arrhythmias. AHI, LSAT, and hypoxic time were no longer statistically significant.

CONCLUSIONS

Our study demonstrated that cardiac arrhythmias are common in patients with OSA in Singapore. It also suggests that given the different demographics of our population, ethnicity may play a significant role in the development of cardiovascular disease among patients with OSA.

COMMENTARY

A commentary on this article appears in this issue on page 1229.

摘要

研究目的

阻塞性睡眠呼吸暂停(OSA)与心血管发病率和死亡率增加有关。心律失常在 OSA 患者中很常见。然而,OSA 亚洲患者心律失常的患病率和意义尚未得到很好的研究。本研究旨在确定新加坡 OSA 患者心律失常的患病率,并评估可能导致 OSA 患者发生心律失常的因素。

方法

对 2011 年 1 月至 2012 年 12 月在一家三级医疗中心的睡眠中心进行的 2019 例患者的回顾性研究。在人群中,发现 1457 例患者患有 OSA,144 例患者患有心律失常。收集的数据包括患者人口统计学、合并症和多导睡眠图参数。

结果

我们的 OSA 人群中心律失常的患病率为 8.0%,而原发性打鼾者为 4.8%(=0.015)。单因素分析显示,年龄较大、体重指数较高、合并症以及 OSA 的严重程度,包括呼吸暂停-低通气指数(AHI)、最低血氧饱和度(LSAT)和缺氧时间与心律失常的高患病率相关(<0.05)。然而,多因素分析显示,只有年龄和体重指数与心律失常显著相关。AHI、LSAT 和缺氧时间不再具有统计学意义。

结论

我们的研究表明,新加坡 OSA 患者心律失常很常见。这也表明,鉴于我们人群的不同人口统计学特征,种族可能在 OSA 患者心血管疾病的发展中起重要作用。

评论

本文的一篇评论文章刊登在本期第 1229 页。

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