Han J, Wang X, Fan J Y, Nie S P, Wei Y X
Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Otalaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2019 Jun 18;99(23):1782-1786. doi: 10.3760/cma.j.issn.0376-2491.2019.23.006.
To investigate the effect of obstructive sleep apnea (OSA) on cardiac structure and function in patients with acute coronary syndrome (ACS). A total of 767 patients with ACS consecutively hospitalized at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017 were enrolled in this study. There were 637 males and 130 females. Patients who met the inclusion criteria according to the sleep apnea hypopnea index (AHI) were examined with portable sleep respiration monitoring. Patients were divided into moderate or severe OSA group (AHI≥15,389) and non or mild OSA group (AHI<15, 78). The general information and echocar diographic results were analyzed. The data fitted normal distribution were compared between the groups with independent sample test. The body mass index [(27.8±3.6) vs (25.8±3.4) kg/m(2), =-7.854, 0.01], neck circumference [(41.1±4.2) vs (39.3±3.2) cm, =-6.717, 0.01] and waist-to-hip ratio (0.99±0.54 vs 0.97±0.53, =-4.735, 0.01) at admission were significantly higher in moderate or severe OSA group than those in non or mild OSA group. The left ventricular end-diastolic diameter, inter-ventricular septum thickness, left atrial diameter,right atrial diameter were all significantly higher, and the E/A peak ratio was remarkably lower in the moderate or severe OSA group (-2.130, 0.278, -3.045, -2.241, 2.260, all 0.05). Moderate or severe OSA may aggravate cardiac remodeling and diastolic function in ACS patients.
探讨阻塞性睡眠呼吸暂停(OSA)对急性冠状动脉综合征(ACS)患者心脏结构和功能的影响。选取2015年6月至2017年5月在北京安贞医院急诊与危重症中心连续住院的767例ACS患者纳入本研究。其中男性637例,女性130例。根据睡眠呼吸暂停低通气指数(AHI)符合纳入标准的患者接受便携式睡眠呼吸监测检查。患者分为中重度OSA组(AHI≥15,389例)和非或轻度OSA组(AHI<15,78例)。分析一般资料和超声心动图结果。符合正态分布的数据采用独立样本t检验进行组间比较。中重度OSA组入院时的体重指数[(27.8±3.6)vs(25.8±3.4)kg/m²,t=-7.854,P=0.01]、颈围[(41.1±4.2)vs(39.3±3.2)cm,t=-6.717,P=0.01]和腰臀比(0.99±0.54 vs 0.97±0.53,t=-4.735,P=0.01)均显著高于非或轻度OSA组。中重度OSA组的左心室舒张末期内径、室间隔厚度、左心房内径、右心房内径均显著增大,E/A峰比值显著降低(t分别为-2.130、0.278、-3.045、-2.241、2.260,均P<0.05)。中重度OSA可能加重ACS患者的心脏重塑和舒张功能。