CAJ | 학술논문

目的：调查老年心血管病患者睡眠呼吸暂停低通气综合征（SAHS）的患病情况。方法采用微动敏感床垫睡眠监测系统对60岁以上住院老年心血管病患者进行睡眠呼吸监测并数据分析。结果127例患者（男性101例，女性26例），平均（76．4±6．8）岁，分别或合并患有冠心病、高血压、各种心律失常以及糖尿病及空腹血糖受损和（或）糖耐量异常、高尿酸血症、慢性肾脏病等。检出 SAHS 107例，患病率84．3％。SAHS 组冠心病患病多于对照组，P ＜0．05；SAHS 患者平均呼吸紊乱指数（AHI）22．6±14．7，其中 AHI≥15者64例，呼吸事件主要为阻塞性，但随着增龄，阻塞性呼吸事件时长减少，低通气事件时长增加。监测血氧饱和度118例均存在夜间低氧血症，重度患者50例占41．7％，最低血氧饱和度（LO2）（79．0±7．2）％，平均血氧饱和度（AO2）（92．8±2．7）％。患者年龄与低通气指数正相关，与 LO2负相关，均 P ＜0．01，在调整呼吸紊乱参数后，年龄与 LO2的负相关依然存在，r ＝-0．223，P ＜0．05。结论老年心血管病患者有很高的 SAHS 和夜间低氧血症患病率，SAHS 的低通气事件加重老年患者随增龄增加的夜间低氧血症。
목적：조사노년심혈관병환자수면호흡잠정저통기종합정（SAHS）적환병정황。방법채용미동민감상점수면감측계통대60세이상주원노년심혈관병환자진행수면호흡감측병수거분석。결과127례환자（남성101례，녀성26례），평균（76．4±6．8）세，분별혹합병환유관심병、고혈압、각충심률실상이급당뇨병급공복혈당수손화（혹）당내량이상、고뇨산혈증、만성신장병등。검출 SAHS 107례，환병솔84．3％。SAHS 조관심병환병다우대조조，P ＜0．05；SAHS 환자평균호흡문란지수（AHI）22．6±14．7，기중 AHI≥15자64례，호흡사건주요위조새성，단수착증령，조새성호흡사건시장감소，저통기사건시장증가。감측혈양포화도118례균존재야간저양혈증，중도환자50례점41．7％，최저혈양포화도（LO2）（79．0±7．2）％，평균혈양포화도（AO2）（92．8±2．7）％。환자년령여저통기지수정상관，여 LO2부상관，균 P ＜0．01，재조정호흡문란삼수후，년령여 LO2적부상관의연존재，r ＝-0．223，P ＜0．05。결론노년심혈관병환자유흔고적 SAHS 화야간저양혈증환병솔，SAHS 적저통기사건가중노년환자수증령증가적야간저양혈증。
Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome (OS-AHS)in the aged patients with cardiovascular disease.Methods The sleep and breath monitoring was performed by using micro -movement sensitive mattress sleep monitoring system (MSMSMS)in 127 hospitalized patients with car-diovascular disease aged more than 60 years old or over at least two nighs for detecting SAHS.Results A total of 127 patients (101 males and 26 females)were included in the study.The average age of patients was (76.4 ±6.8) years.The patients were alone or complicated with coronary heart disease,hypertension,arrhythmias,heart failure,or/and diabetes and impaired fasting glucose and (or)glucose tolerance abnormalities,hyperuricemia and chronic kidney disease.There were totally 107 cases with OSAHS (84.3%).The number of cases with coronary heart disease in SAHS group was more than that in the control group.The mean apnea hypopnea index (AHI)was (22.6 ±14.7), of which 64 cases were AHI≥15.The majority were obstructiverespiratory events.However,with the increase in the age,the decreased length of obstructive respiratory events and increased length of hypopnea events were observed. Nocturnal hypoxemia was detected in all of 118 cases who received monitoring of oxygen saturation,of which 50 cases (41.7%)were severe.The average level of lowest oxygen saturation(LO2 )was (79.0 ±7.2)% and mean oxygen saturation(AO2 )was (92.8 ±2.7)%.The age of patients was significantly positively correlated with HI and nega-tively correlated with LO2 (P <0.01).The negative correlation between age and LO2 was still present after the adjust-ment of the parameters of breathing disorder(r =-0.223,P <0.05).Conclusions The prevalence of OSAHS and nocturnal hypoxemia disease is high in the aged patients with cardiovascular diseases.The hypopnea events of OSAHS aggravate the nocturnal hypoxemia,which is increased with age in the aged patients.