中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
40期
3277-3280
,共4页
苏士成%丁宁%朱先极%张希龙%喻荣彬
囌士成%丁寧%硃先極%張希龍%喻榮彬
소사성%정저%주선겁%장희룡%유영빈
睡眠呼吸暂停综合征%心房颤动%心力衰竭%疾病特征
睡眠呼吸暫停綜閤徵%心房顫動%心力衰竭%疾病特徵
수면호흡잠정종합정%심방전동%심력쇠갈%질병특정
Sleep apnea syndrome%Atrial fibrillation%Heart failure%Disease attributes
目的 分析心衰合并心房颤动(房颤)患者睡眠呼吸暂停综合征(SAS)的发生情况及临床特征.方法 对2012年6月至2014年6月期间在南京医科大学第一附属医院住院的心衰患者进行心电图筛选出110例房颤患者(合并房颤组) ,同时将年龄、性别、体质指数相匹配的105例无房颤的单纯心衰患者(单纯心衰组)作为平行对照,对比观察及分析两组患者SAS的发病情况及特征.结果 两组在心衰病因、合并症、纽约心脏病协会(NYHA)分级、基础用药方面差异均无统计学意义.合并房颤组白日Epworth 嗜睡量表评分和心胸比均显著高于单纯心衰组[ (10.1 ±5.8)比(8.2 ± 5.5)分和0.63 ±0.08比0.57 ±0.07,均P<0.05],而6 min步行距离显著短于单纯心衰组[(305 ± 70)比(335 ±69)m,P<0.05].两组患者左室射血分数、左室舒张末内径、左室收缩末内径差异均无统计学意义,而合并房颤组左房内径显著大于单纯心衰组(P<0.05).合并房颤组SAS发生比例显著高于单纯心衰组(36.4%比20.0%,P<0.05),睡眠呼吸暂停低通气指数也显著高于单纯心衰组[4(1,16)比3(1,7)次/h,P<0.05],而其他多导睡眠监测指标如快动眼睡眠时间百分比、觉醒指数、平均氧饱和度、最低氧饱和度、氧减指数等差异均无统计学意义(均P>0.05).结论 心衰合并房颤患者比单纯心衰患者更易发生SAS,且白日嗜睡更重,活动能力更差.
目的 分析心衰閤併心房顫動(房顫)患者睡眠呼吸暫停綜閤徵(SAS)的髮生情況及臨床特徵.方法 對2012年6月至2014年6月期間在南京醫科大學第一附屬醫院住院的心衰患者進行心電圖篩選齣110例房顫患者(閤併房顫組) ,同時將年齡、性彆、體質指數相匹配的105例無房顫的單純心衰患者(單純心衰組)作為平行對照,對比觀察及分析兩組患者SAS的髮病情況及特徵.結果 兩組在心衰病因、閤併癥、紐約心髒病協會(NYHA)分級、基礎用藥方麵差異均無統計學意義.閤併房顫組白日Epworth 嗜睡量錶評分和心胸比均顯著高于單純心衰組[ (10.1 ±5.8)比(8.2 ± 5.5)分和0.63 ±0.08比0.57 ±0.07,均P<0.05],而6 min步行距離顯著短于單純心衰組[(305 ± 70)比(335 ±69)m,P<0.05].兩組患者左室射血分數、左室舒張末內徑、左室收縮末內徑差異均無統計學意義,而閤併房顫組左房內徑顯著大于單純心衰組(P<0.05).閤併房顫組SAS髮生比例顯著高于單純心衰組(36.4%比20.0%,P<0.05),睡眠呼吸暫停低通氣指數也顯著高于單純心衰組[4(1,16)比3(1,7)次/h,P<0.05],而其他多導睡眠鑑測指標如快動眼睡眠時間百分比、覺醒指數、平均氧飽和度、最低氧飽和度、氧減指數等差異均無統計學意義(均P>0.05).結論 心衰閤併房顫患者比單純心衰患者更易髮生SAS,且白日嗜睡更重,活動能力更差.
목적 분석심쇠합병심방전동(방전)환자수면호흡잠정종합정(SAS)적발생정황급림상특정.방법 대2012년6월지2014년6월기간재남경의과대학제일부속의원주원적심쇠환자진행심전도사선출110례방전환자(합병방전조) ,동시장년령、성별、체질지수상필배적105례무방전적단순심쇠환자(단순심쇠조)작위평행대조,대비관찰급분석량조환자SAS적발병정황급특정.결과 량조재심쇠병인、합병증、뉴약심장병협회(NYHA)분급、기출용약방면차이균무통계학의의.합병방전조백일Epworth 기수량표평분화심흉비균현저고우단순심쇠조[ (10.1 ±5.8)비(8.2 ± 5.5)분화0.63 ±0.08비0.57 ±0.07,균P<0.05],이6 min보행거리현저단우단순심쇠조[(305 ± 70)비(335 ±69)m,P<0.05].량조환자좌실사혈분수、좌실서장말내경、좌실수축말내경차이균무통계학의의,이합병방전조좌방내경현저대우단순심쇠조(P<0.05).합병방전조SAS발생비례현저고우단순심쇠조(36.4%비20.0%,P<0.05),수면호흡잠정저통기지수야현저고우단순심쇠조[4(1,16)비3(1,7)차/h,P<0.05],이기타다도수면감측지표여쾌동안수면시간백분비、각성지수、평균양포화도、최저양포화도、양감지수등차이균무통계학의의(균P>0.05).결론 심쇠합병방전환자비단순심쇠환자경역발생SAS,차백일기수경중,활동능력경차.
Objective To evaluate the occurrence and clinical characteristics of sleep apnea syndrome (SAS) in heart failure (HF) patients with atrial fibrillation (AF).Methods From HF patients hospitalized in the First Affiliated Hospital of Nanjing Medical University during June 2012 and June 2014, subjects were recruited based on electrocardiography examination , including 110 patients with AF (coexisting AF group) and 105 parallel control patients without AF but with matched age , gender and body mass index (simple HF group).Comparison was made about the occurrence and characteristics of SAS between two groups.Results There was no statistical difference in causes of HF , complications, New York Heart Association class and basic medication between two groups.Compared with the patients in simple HF group, the patients in coexisting AF group had a significantly higher Epworth sleepiness scale score , larger cardiothoracic ratio (10.1 ±5.8 vs 8.2 ±5.5, 0.63 ±0.08 vs 0.57 ±0.07; both P<0.05), and shorter 6-minute walk distance [(305 ±70) vs (335 ±69) m, P <0.05].There was no difference in left ventricular ejection fraction , left ventricular end-diastolic dimension and left ventricular end-systolic dimension between two groups.However , left atrial diameter was remarkably larger in coexisting AF group than that in simple HF group (P<0.05).The prevalence of SAS was higher in coexisting AF group than that in simple HF group (36.4%vs 20.0%, P<0.05).Compared with simple HF group, the coexisting AF group had a higher apnea/hypopnea index [4(1, 16) vs 3(1, 7) times/h, P<0.05].No significant differences were detected between two groups among the rapid of eye movement sleep stage /total sleep time ,arousal index , mean and lowest pulse oxygen saturation (SpO2) and oxygen desaturation index.Conclusion HF patients with AF have a higher frequency of SAS , more severe daytime sleepiness and poorer physical activity than matched simple HF patients without AF.
