Peters A J, Perings C, Schwalen A, Steiner S, Hennersdorf M, Strauer B E, Leschke M
Medizinische Klinik und Poliklinik B, Klinik für Kardiologie, Angiologie und Pneumologie, Heinrich-Heine-Universität Düsseldorf.
Pneumologie. 1997 Jun;51(6):580-5.
Patients with untreated sleep apnea syndrome have a higher cardiovascular mortality. It is not known which mechanisms lead to this increase in mortality and whether it is independent from the often associated coronary heart disease and systemic hypertension. In 48 consecutive patients with coronary heart disease confirmed by angiography, exercise-ECG, Holter-ECG, echocardiography, spirometric tests, analysis of ventricular late potentials, heart rate variability and a test for sleep-disordered breathing with a screening device were performed. Seventeen patients showed disordered breathing during sleep (obstructive sleep apnea) with a desaturation index of > or = 10 (mean desaturation index 17.3 +/- 9.3 vs. 2.6 +/- 3.1 in the patients without sleep-disordered breathing). There are no significant differences in age (58.9 +/- 6.1 vs. 59.7 +/- 7.6 years), body-mass-index (28.6 +/- 3.7 vs. 27.7 +/- 3.3 kg/m2), left ventricular ejection fraction (57.2 +/- 13.6 vs. 64.0 +/- 14.6%), forced expiratory volume in 1 second/vital capacity 95.4 +/- 13.9 vs. 92.9 +/- 11.2% predicted, heart rate variability (standard deviation of the RR-intervals 39.4 +/- 29.4 vs. 37.2 +/- 17.0 ms), the frequency of premature ventricular beats over 24 h and at night, the frequency of multivessel disease (71 vs. 68%), additional hypertension 53 vs. 48%), status postmyocardial infarction (47 vs. 48%) and positive late potential analysis (24 vs. 13%). There were no ST segment depressions during the night. Patients with coronary heart disease and mild sleep-disordered breathing show no significant differences in the investigated parameters compared with patients without obstructive sleep apnea or sleep-disordered breathing.
未经治疗的睡眠呼吸暂停综合征患者心血管死亡率较高。目前尚不清楚是哪些机制导致了这种死亡率的增加，以及它是否独立于常与之相关的冠心病和系统性高血压。对48例经血管造影、运动心电图、动态心电图、超声心动图、肺活量测定、心室晚电位分析、心率变异性分析以及使用筛查设备进行睡眠呼吸障碍检测确诊为冠心病的连续患者进行了研究。17例患者睡眠期间出现呼吸紊乱（阻塞性睡眠呼吸暂停），去饱和指数≥10（平均去饱和指数为17.3±9.3，而无睡眠呼吸紊乱的患者为2.6±3.1）。在年龄（58.9±6.1岁对59.7±7.6岁）、体重指数（28.6±3.7kg/m²对27.7±3.3kg/m²）、左心室射血分数（57.2±13.6%对64.0±14.6%）、一秒用力呼气量/肺活量（预测值的95.4±13.9%对92.9±11.2%）、心率变异性（RR间期标准差39.4±29.4ms对37.2±17.0ms）、24小时及夜间室性早搏频率、多支血管病变频率（71%对68%）、合并高血压情况（53%对48%）、心肌梗死后状态（47%对48%）以及晚电位分析阳性率（24%对13%）方面，两组无显著差异。夜间无ST段压低。与无阻塞性睡眠呼吸暂停或睡眠呼吸紊乱的患者相比，患有冠心病且伴有轻度睡眠呼吸紊乱的患者在研究参数方面无显著差异。
