超声评价睡眠呼吸暂停综合征患者左心室构型与颈动脉结构和功能的相关性

目的评价阻塞性睡眠呼吸暂停综合征（OSAS）患者左心室构型与颈动脉结构和功能的相关性。方法收集2010年10月至2012年3月在山西医科大学第一医院经多导睡眠仪监测呼吸暂停指数（AHI）≥5次/h确诊为OSAS的患者92例,次日8：00行血糖和血脂等生化检查及超声心动图检查。根据相对室壁厚度（RWT）≥0.42和左心室质量指数（LVMI）≥46.7 g/m^2.7（女）或49.2 g/m^2.7（男）,将患者按左心室构型分为正常构型组（NG）、向心性重构组（CR）、向心性肥厚组（CH）和离心性肥厚组（EH）。使用超声诊断仪记录OSAS患者颈动脉斑块、内中膜厚度（IMT）、内径（D）、内径变化幅度（Dis）、扩张性（DC）、顺应性（CC）、脉搏波传导速度（PWV）、僵硬度指标α、β,应用直线相关分析分析OSAS患者左心室构型与颈动脉结构和功能的相关性。结果（1）颈动脉结构与功能参数：与NG组相比,CR组α、PWV增高（q=2.90、2.93,P均〈0.05）,EH组IMT、PWV、α、β、D增高（q=3.51、3.53、3.50、3.51、3.55,P均〈0.05）,CH组IMT、PWV、α、β、D、CC增高（q=3.87、3.90、3.89、3.91、3.90、3.94,P均〈0.05）;与CR组相比,EH组IMT、PWV、β、D增高（q=2.92、2.90、2.93、2.92,P均〈0.05）,CH组IMT、PWV、β、D、Dis增高（q=3.54、3.53、3.50、3.53、3.51,P均〈0.05）;与EH组相比,CH组IMT增高（q=2.94,P〈0.05）。（2）直线相关分析显示：LVMI与IMT、PWV呈明显正相关（r=0.41、0.48,P均〈0.01）。结论不同左心室构型的OSAS患者颈动脉结构和功能受损程度不一致;OSAS患者左心室向心性肥厚和离心性肥厚构型与颈动脉结构和功能受损相关。

Relationship between left ventricular geometric patterns and the structure and elasticity of common carotid artery in patients with obstructive sleep apnea syndrome by ultrasound

Objective To investigate the correlation between left ventricular（LV） geometric patterns and the structure and elasticity of the common carotid artery（CCA） in patients with obstructive sleep apnea syndrome（OSAS） by ultrasound.Methods A total of 92 patients with habitual snoring were diagnosed as OSAS by polysomnography with apnea hypopnea index（AHI） ≥5 times per hour.General clinical characteristics were collected and echocardiography was conducted next morning.LV geometric patterns was categorized as normal geometry（NG）,concentric remodeling（CR）,concentric hypertrophy（CH） and eccentric hypertrophy（EH） on the basis of relative wall thickness（RWT） ≥0.42 and left ventricular mass index（LVMI） ≥46.7 g/m^2.7（female） or 49.2 g/m^2.7（male）.The structural parameters of CCA included intima-media thickness（IMT）,diameter（D） and plaques.The elasticity parameters of CCA including distension（Dis）,distensibility coefficient（DC）,compliance coeffi cient（CC）,pulse wave velocity（PWV）,stiffness index α and β were collected by quality intima-media thickness（QIMT） and quality arterial stiffness（QAS）.The correlation of LV geometric patterns and the structure and elasticity of CCA in patients with OSAS were analyzed by Pearson correlation analysis.Results（1） Structural and elastic parameters of CCA：Compared with NG group,α,PWV increased in CR group（q=2.90,2.93,both P 〈0.05）,IMT,PWV,α,β,D increased in EH group（q=3.51,3.53,3.50,3.51,3.55,all P 〈0.05）,IMT,PWV,α,β,D,CC increased in CH group（q=3.87,3.90,3.89,3.91,3.90,3.94,all P 〈0.05）.Compared with CR group,IMT,PWV,β,D increased in EH group（q=2.92,2.90,2.93,2.92,all P〈0.05）,IMT,PWV,β,D,Dis increased in CH group（q=3.54,3.53,3.50,3.53,3.51,all P〈0.05）.Compared with EH group,IMT increased in CH group（q=2.94,P〈0.05）.（2） By Pearson correlation analysis,LVMI had positive relationship with IMT and PWV（r=0.41,0.48,both P〈0.01）.Conclusions The damaged deg