摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者微觉醒与夜间心率变异(HRV)的关系。方法本研究对象为27例经整夜多导睡眠图(PSG)诊断为中重度 OSAHS 的患者。所有患者每人选择1h 连续非快速动眼睡眠(NREM)的 PSG 记录,将1h 内每个呼吸紊乱相关微觉醒开始前10s 的平均心率(HR)和微觉醒开始后10s 的最高 HR 进行比较,同时计算1h 内呼吸紊乱相关微觉醒指数(B-ArI)和脉率升高指数(PRRI)并作相关分析。此外对18例中重度 OSAHS 患者选择NREM 睡眠时10个不伴微觉醒的事件和10个伴有微觉醒的事件[按最低动脉血氧饱和度(minSaO_2)进行匹配],比较两组事件终止前后心率变化(ΔHR)。结果微觉醒开始后10s 的最高 HR[(81.6±9.4)次/min]显著高于微觉醒开始前10s 的平均 HR[(69.6±7.3)次/min,t=-14.87、P<0.01],且 B-ArI 与 PRRI 呈显著正相关(r=0.97,P<0.01),伴有微觉醒的呼吸事件终止前后ΔHR[(11.1±2.8)次/min]显著高于不伴微觉醒的呼吸事件[(7.0±2.4)次/min,t=4.702、P<0.01]。结论 B-ArI 与夜间 HRV 相关,提示微觉醒可影响心血管调节功能,频繁的微觉醒是导致 OSAHS 患者心血管后果的重要原因之一。
Objective To investigate the relationship between arousal and nocturnal heart rate variability （HRV） in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Twenty-seven patients with moderate to severe OSAHS who underwent overnight polysomnography （PSG） were enrolled, excluding patients with cardiopulmonary and nervous system diseases. An hour continuous PSG monitoring in non-rapid eye movement （NREM） was recorded for all patients. The mean heart rate （HR） in 10 s before each arousal and the peak HR in 10 s after arousal were compared,and the breathing disorder related arousal index （B-ArI） and pulse rate rise index （PRRI） were calculated at this time, and then a correlation analysis was performed. Furthermore, according to minimal oxygen saturation （ minSaO2 ）, 18 patients with moderate-to-severe OSAHS were matched into 10 events with and without EEG arousal in NREM, and then AHR at apnea termination between these events were compared. Results The peak HR in 10 s after arousal onset[ （81.6±9.4）beats/min] was significantly higher than the mean HR in 10 s before arousal onset[ （69.6±7.3） beats/min,t=-14. 87 ,P 〈0. 01] ,and B-ArI was positively correlated to PRRI （ r=0.97, P 〈 0. 01 ）. The ΔHR of events with EEG arousal at apnea termination[ （ 11.1±2. 8 ） beats/min ] was higher than those without EEG arousal [ （ 7.0±2. 4 ） beats/min, t = 4. 702, P 〈 0. 01 ]. Conclusions The results indicate that arousal can influence the function of cardiovascular regulation. Frequent arousal is one of the main causes of the cardiovascular consequences in OSAHS patients.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2006年第4期233-235,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
