摘要
目的初步探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea/hypopneasyndrome,OSAHS)对左心室收缩功能的影响。方法98例入选者分为OSAHS合并左室收缩功能不全组(试验组21例)、OSAHS无左室收缩功能不全组(OSAHS组47例)和无OSAHS、左室收缩功能不全组(对照组30例)。在多导睡眠图监测下,次晨抽取外周静脉血测定血浆内皮素(ET)。结果①试验组SpO2Low(整夜睡眠监测中患者最低脉搏血氧饱和度)低于另两组(P<0.05),平均呼吸暂停时间、%TST-SpO2<90%(一整夜睡眠监测中患者脉搏血氧饱和度低于90%时间占整个睡眠监测时间的百分比)、%TST-SpO2<80%、血浆ET含量均高于另两组(P<0.05);试验组和OSAHS组呼吸暂停低通气指数(AHI)、最长暂停时间无差异。②两组OSAHS患者血浆ET均与%TST-SpO2<90%(r=0.457,P=0.021;r=0.415,P=0.026)、%TST-SpO2<80%(r=0.372,P=0.016;r=0.334,P=0.031)呈正相关,试验组左室射血分数与%TST-SpO2<80%(r=-0.529,P=0.024)、血浆ET(r=-0.485,P=0.041)呈负相关。结论OSAHS患者反复长时间的呼吸暂停、中重度低氧血症和高水平血浆ET可能对左室收缩功能有重要的影响。
Objective To explore the influence of OSAHS on left ventricular systolic function damage. Methods Ninety-eight patients were assigned to three groups： OSAHS with left ventricular systolic dysfunction（21 cases）,OSAHS without left ventricular systolic dysfunction（47 cases） and control group （30 cases） by overnight polysomnography, echocardiography and gated radionuclide angiography. In the following morning,their plasma endothelin were measured. Results ①The SpO2Low in OSAHS with left ventricular systolic dysfunction is significantly lower than the other two groups （ P〈0.05）. Mean apnea duration, %TST-SpO2〈90%, %TST-SpO2 〈80% and plasma endothelin were significantly higher than the other two groups （ P〈0.05）. Compare with OSAHS without left ventricular systolic dysfunction,AHI and LAT were no significant different. The SpO2 Low in OSAHS without left ventricular systolic dysfunction is significantly lower than control group （ P〈0.05）. Mean apnea duration, %TST SpO2〈90 % and %TST- SpO2〈80% were significantly higher than control group （ P〈0.05）. ②Correlation analysis results： the plasma endothelin of OSAHS patients in two groups were all positively related to %TST-SpO2〈90 % （ r = 0. 457, P =0. 021; r =0. 415, P =0. 026） and %TST-SpO2〈80% （ r =0. 372, P =0. 016; r =0. 334, P =0. 031）,LVEF in OSAHS with left ventricular systolic dysfunction was negatively correlated to %TST SpO2〈80% （ r = -0. 529, P =0. 024） and plasma endothelin（ r =-0. 485, P =0. 041）. Conclusions Recurrent long-time apnea, midrange and severe hypoxemia and elevated plasma endothelin may be the essential mechanism of OSAHS resulting in left ventricular systolic dysfunction.
出处
《国外医学（呼吸系统分册）》
2005年第11期810-812,共3页
Section of Respiratory System Foreign Medical Sciences
基金
福建省科技厅资助项目(编号:98-Z-163)
