阻塞性睡眠呼吸暂停低通气综合征合并心血管疾病患者通气功能和睡眠结构的变化

 目的探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea/hypopnea syndrome,OSAHS)合并心血管疾病患者通气功能和睡眠结构的变化,观察经鼻持续气道正压通气的治疗效果.方法监测单纯鼾症组,鼾症合并心血管疾病组,OSAHS组,以及OSAHS合并心血管疾病组患者低通气指数、呼吸暂停指数、呼吸暂停低通气指数、最低血氧饱和度、觉醒指数及睡眠分期的变化.随机选择OSAHS合并心血管疾病患者28例实施经鼻持续气道正压通气治疗.结果 OSAHS合并心血管病组的呼吸暂停指数高于单纯OSAHS组(P＜0.05).OSAHS合并心血管疾病组的觉醒指数和3+4期睡眠时间明显小于单纯OSAHS患者(P＜0.01或P＜0.05).OSAHS合并心血管疾病患者经持续气道正压通气治疗后呼吸暂停低通气指数显著降低(P＜0.05),最低氧饱和度明显升高(P＜0.05);重度组2期睡眠明显减少(P＜0.01);重度组3+4期睡眠明显增加(P＜0.05).结论 OSAHS合并心血管疾病患者有明显的通气功能和睡眠结构紊乱,经鼻持续气道正压通气治疗后通气功能和睡眠结构紊乱明显改善.

Changes in ventilation function and sleep structure in patients with obstructive sleep apnea/hypopnea syndrome accompanied by cardiovascular disease

Objective To study the changes in ventilation function and sleep structure in patients with obstructive sleep apnea/hypopnea syndrome(OSAHS) accompanied by cardiovascular disease and assess the efficacy of nasal continuous positive airway pressure(nCPAP).Method The sleep structure,hypopnea index(HI),apnea index(AI),apnea-hypopnea index(AHI),and minimum oxygen saturation(MinSaO_2) were analyzed in OSAHS patients with and without cardiovascular disease,and snoring patients with and without cardiovascular disease as controls.Twenty-eight OSAHS patients with cardiovascular disease were monitored before and after nCPAP therapy.Result AI in OSAHS with cardiovascular disease group were significantly higher than those in OSAHS alone group(P<0.05).The time periods of awakening and stage 3,4 sleep in OSAHS with cardiovascular disease group were significantly shorter than those in OSAHS alone group(P<(0.01),P<0.05).The nCPAP therapy among mild to severe OSAHS patients with cardiovascular disease led to improvement in polysomnographic indices: AHI significantly decreased(P<0.05) while MinSaO_2 increased(P<0.05).The time periods of stage 3,4 sleep in severe group were significantly prolonged(P<0.05) whereas the time period of stage 2 was significantly shortened(P<0.01).Conclusions The ventilation function and sleep structure are significantly disordered in OSAHS patients with cardiovascular disease.The nCPAP therapy efficiently improves the morbid condition in such patients.