摘要
目的探讨睡眠期间发生缓慢性心律失常的阻塞性睡眠呼吸暂停（OSA）患者的临床特点，并分析缓慢性心律失常的发生与血氧饱和度下降的关系。方法1999年9月至2005年4月对北京阜外心血管病医院和北京同仁医院确诊的203例OSA的患者，在接受多导睡眠仪睡眠检查后2周内进行24h动态心电图检查，分析其发生缓慢性心律失常患者的临床特点。结果与未合并缓慢性心律失常者相比，夜间发生缓慢性心律失常的OSA患者体重指数增高（24±6比34±5，P〈0．05）；呼吸紊乱指数增高[（25±5）次／h比（63±15）次／h，P〈0．01]；最低血氧饱和度下降[（75±11）％比（63±15）％，P〈0．05]，但缓慢性心律失常的发生与最低血氧饱和度间没有明确的线性关系。结论肥胖而严重的OSA患者睡眠期间缓慢性心律失常的发生率增高。在心律失常诊治过程中，尤其是对夜间发生缓慢性心律失常的患者，应该考虑到OSA的存在。
Objective To analyze the relations between obstructive sleep apnea and bradyarrhythmia. Methods From 1999 to 2005, 203 patients who came from Beijing Tongren Hospital and Fuwai Hospital were found to have sleep apnea in an ambulatory study. A Hoher electrocardiogram was recorded for 24 hours within 2 weeks after patients were diagnosed as obstructive sleep apnea. Results Nocturnal episodes of bradyarrhythmia were identified in 12 （5.9%） of 203 patients. Body mass index and respiratory disturbance index in patients with bradyarrhythmia （n = 12 ） were higher than those in patients withour bradyarrhymia （ n = 191 ） （34 ± 5 vs. 24 ± 6 and 63 ± 15 vs. 25 ±5, respectively, both P 〈 0.01 ）. There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia （63 %± 15 % vs. 75 % ± 11% , P 〈 0. 05 ）. A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks was not found. Conclusions Patients with apnea-associated bradyarrhythmia have higher body mass index and higher respiratory disturbance index than patients without bradyarrhythmia. Bradyarrhythmia occurres independently from decrease in oxygen saturation.
出处
《中华全科医师杂志》
2009年第7期455-457,共3页
Chinese Journal of General Practitioners
