成人打鼾者阻塞性睡眠呼吸暂停低通气综合征与心血管疾病的关系

Rui Wu , Xilong Zhang , Ling Hu , Enzhi Jia
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引用次数: 3

摘要

目的探讨成人习惯性打鼾患者睡眠呼吸暂停低通气综合征(OSAHS)与心血管疾病的关系及鼻持续气道正压通气(NCPAP)对OSAHS患者的治疗效果。方法采用多导睡眠描记仪对262例成人习惯性打鼾者进行检查,并将其分为OSAHS组和非OSAHS组(对照组)。采用动态心电图和血压测量,监测两组患者在NCPAP治疗前后的每日夜间血压节律、高血压、心率变异性、部分冠心病心律失常和心绞痛情况,并进行比较。结果成人打鼾者OSAHS发病率(39.6%)较高,且OSAHS组高血压发生率明显高于非OSAHS组,每日夜间血压节律消失,硝酸盐治疗冠心病心绞痛效果差,睡眠心率变异性降低,心律失常增加,SpO2水平降低。睡眠期间NCPAP治疗后,OSAHS组SpO2明显升高,呼吸暂停低通气指数明显降低;心率变异性和每日夜间血压节律恢复正常水平。结论OSAHS的发生与部分心血管疾病有密切关系。此外,NCPAP治疗不仅对OSAHS有效,而且对合并的心血管疾病也有效。
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Relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular disorders in adult snorers

Objective

To investigate the relationship between sleep apnea hypopnea syndrome(OSAHS) and some cardiovascular disorders in adult habitual snorers as well as the effectiveness of nasal continuous positive airway pressure(NCPAP) on those with OSAHS.

Methods

With the use of polysomnography, 262 adult habitual snorers were examined and divided into the OSAHS group and the Non-OSAHS group (control). Using ambulatory electrocardiogram and blood pressure measurement, daily nocturnal rhythm of blood pressure, hypertension, heart rate variability, some arrythmias and angina pectoris of coronary heart disease were monitored and compared between the two groups, before and after 14 days of treatment with NCPAP in the OSAHS group.

Results

This study indicated a higher incidence (39.6%) of OSAHS in adult snorers and demonstrated that there was a significantly higher incidence of hypertension, disappearance of the daily nocturnal rhythm of blood pressure, poor effectiveness of nitrate on angina pectoris of coronary heart disease, decreased heart rate variability during sleep, increased arrythmias and lower SpO2 levels in the OSAHS group than in the Non-OSAHS group. After NCPAP treatment during sleep, snoring control, significantly higher SpO2 and lower apnea hypopnea indices were achieved in the OSAHS group; heart rate variability and daily nocturnal rhythm of blood pressure returned to normal levels.

Conclusion

The results of this research suggested that there was a close relationship between the development of OSAHS and some cardiovascular disorders. Furthermore, NCPAP treatment was effective not only on OSAHS but also on coexisting cardiovascular disorders.

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