CAJ | 학술논문

目的:观察冠心病(CHD)患者中阻塞性睡眠呼吸暂停综合征(OSAS)的患病率,探讨OSAS与CHD的关系.方法:83例可疑CHD的患者行冠状动脉造影,依据造影结果分为CHD组(48例),冠状动脉造影阴性组(35例), 83例患者均行多导睡眠仪(PSG)监测,依据PSG监测得出的睡眠呼吸暂停低通气指数(AHI)分为轻度OSAS组(10≤AHI<20, 23例)、中重度OSAS组(AHI≥20,21例)和非OSAS组(对照组,AHI<10, 39例).3组均计算Gensini评分,用于评估冠状动脉粥样硬化病变的程度.用Logistic回归评估OSAS以及其他危险对CHD的影响.结果:CHD组中OSAS的患病率高于冠状动脉造影阴性组.轻度和中重度OSAS组,最低血氧饱和度低于对照组;CHD患病率高于对照组;冠状动脉病变单支受累百分率显著高于对照组,多支受累百分率高于对照组;中重度OSAS组的Gensini评分显著高于对照组.多因素Logistic回归得出OSAS、高血压以及脂蛋白(a)与CHD独立相关.结论:在冠状动脉造影证实的CHD患者中OSAS患病率较高,多因素回归发现OSAS与CHD独立相关,OSAS可能是导致冠心病的一个重要的独立危险因素.
목적:관찰관심병(CHD)환자중조새성수면호흡잠정종합정(OSAS)적환병솔,탐토OSAS여CHD적관계.방법:83례가의CHD적환자행관상동맥조영,의거조영결과분위CHD조(48례),관상동맥조영음성조(35례), 83례환자균행다도수면의(PSG)감측,의거PSG감측득출적수면호흡잠정저통기지수(AHI)분위경도OSAS조(10≤AHI<20, 23례)、중중도OSAS조(AHI≥20,21례)화비OSAS조(대조조,AHI<10, 39례).3조균계산Gensini평분,용우평고관상동맥죽양경화병변적정도.용Logistic회귀평고OSAS이급기타위험대CHD적영향.결과:CHD조중OSAS적환병솔고우관상동맥조영음성조.경도화중중도OSAS조,최저혈양포화도저우대조조;CHD환병솔고우대조조;관상동맥병변단지수루백분솔현저고우대조조,다지수루백분솔고우대조조;중중도OSAS조적Gensini평분현저고우대조조.다인소Logistic회귀득출OSAS、고혈압이급지단백(a)여CHD독립상관.결론:재관상동맥조영증실적CHD환자중OSAS환병솔교고,다인소회귀발현OSAS여CHD독립상관,OSAS가능시도치관심병적일개중요적독립위험인소.
Objective:The aim of our study was to assess the prevalence of obstructive sleep apnea syndrome(OSAS) in patients with chest pain and angiographically verified coronary artery disease(CHD).Additionally we analyzed the association of OSAS and coronary risk factors with CHD.Method:83 consecutive selection patients were classified into two groups according to the coronary angiography(CAG) results: CHD group(48 patients with verified CHD);normal group(35 patients with exclusion of CHD).Overnight polysomography(PSG)recordings for detection of OSAS was performed in 83 patients. They were divided into three groups based on their nocturnal apnea hypopnea index (AHI) detected by examination of polysomnography(PSG),mild OSAS group(10≤AHI<20,23 cases),moderate-to-severe group(AHI≥20,21 cases)and control group (AHI<10,39cases). Gensini Score for assessing the severity of coronary atherosclerosis were made in all three groups.Mutiple logistic regression analysis was performed to assess OSAS and other coronary risk factors with CHD.Results:CHD patients were found to have higher morbidity rate of OSAS than that in normal subjects.Compared with the control group,AHI was significantly higher in OSAS groups. The minimal Sp02 were significantly lower in OSAS groups than that in the control group.The incidence of CHD was significantly higher in OSAS groups than that in the control group.The percentage of patients with single-coronary-vessel disease was higher in OSAS group than in control group.The patients with multi-coronary-vessel disease were higher in OSAS group than that in control group.Gensini Score was significantly higher in moderate-to-severe OSAS group than that in control group.OSAS、hypertension and LP(a) were independently associated with CHD.Conclution:There is a high occurrence of OSAS in patients with angiographically verified CHD.OSAS is independently associated with CHD.OSAS might be a significant independent risk factor of coronary atherosclerosis.