阻塞性睡眠呼吸暂停低通气综合征与颈动脉斑块的相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与颈动脉斑块和颈动脉内-中膜厚度的关系。方法选取2013年1月~2014年12月期间在瑞金医院老年科住院并具有打鼾、白天嗜睡等OSAHS症状的患者120例,对其进行多导联睡眠监测(PSG),根据呼吸暂停低通气指数(AHI)将其分为OSAHS组(80例)和非OSAHS组(40例),并将OSAHS组分为轻度组(25例)、中度组(26例)、重度组(29例),对所有入选者用彩色多普勒超声检测颈动脉内-中膜厚度(IMT)、血流阻力指数(RI)和颈动脉斑块。结果 OSAHS各指标及其严重程度在合并斑块组与无斑块组未见明显差异;夜间最低血氧饱和度(min Sa O2)、夜间氧饱和度低于90%的时间占总睡眠时间的百分比(TS90)均与颈动脉IMT、RI相关,且右侧颈动脉更明显;Logistic回归分析发现年龄升高是颈动脉斑块发病的独立危险因素,且年龄分层在合并斑块组与无斑块组可见显著差异。结论 OSAHS所致的缺氧与颈动脉粥样硬化的形成密切相关;年龄升高是颈动脉斑块形成的独立危险因素。

Relativity Study Between Obstructive Sleep Apnea Hypopnea Syndrome and Carotid-Ar-tery Plaque

Objective We investigated whether obstructive sleep apnea hypopnea syndrome( OSAHS) was associated with the carotid-artery plaque and the carotid-artery intima-media thickness(IMT). Methods We selected 120 hospitalized patients from the Geriatric Department in Ruijin hospital during January 2013-December 2014. They had OSAHS symptoms such as snoring,daytime sleepiness and so on. All subje nea-hy-popnea index ( AHI ) . Color Doppler ultrasonography was used to measure the carotid-artery intima-media thickness( IMT) ,blood flow resistance index( RI) and carotid-artery plaque. Results The severity of OSAHS was not significantly associated with the carotid-artery plaque. But the nadir oxygen saturation(minSaO2)dur-ing night and the duration of an oxygen saturation below 90%,which is expressed as a percentage of the total sleeping time(TS90)was correlated with the carotid-artery IMT and RI. Moreover,the relationship was more obvious in the right carotid artery. It was found that age was independently related to the formation of carotid-artery plaque by using the Logistic regression analysis. The age stratification was significantly associated with the carotid-artery plaque. Conclusion OSAHS-related hypoxemia is closely associated to carotid-artery ather-osclerosis. Age is an independent risk factor of carotid-artery atherosclerosis.