阻塞性睡眠呼吸暂停综合征引起冠心病急性发作并激发恶性心律失常三例报道

报道3例阻塞性睡眠呼吸暂停综合征(OSAS)病人，例1表现OSAS诱发心绞痛逐渐演变为急性心肌梗死，例2在急性心肌梗死过程中引起高度窦房、房室阻滞和心脏停搏，例3在急性心肌梗死基础上每有呼吸暂停发作便激发出室速和(或)室颤。治疗中，例2应用吗啡类可能加重了呼吸暂停程度；抗心律失常药和电复律效果在例3中表现欠佳。因此，OSAS诱发心梗并激发恶性心律失常的事件，在冠心病抢救中应引起充分认识和足够重视。

Coronary Heart Disease Attack and Malignant Arrhythmia Triggered off by Obstructive Sleep Apnea Syndrome

Background and Methods:Coronary heart disease (CHD) attack induced by obstructive sleep apnea syndrome (OSAS) is well-documented in retrospective study, but acute myocardial infarction (AMI) and malignant arrhythmia triggered in acute stage,especially in superacute stage,are less-known.Three patients with AMI and OSAS were observed. Results:The first one with angina pectoris confirmed before,resulted in AMI,owing to serious OSAS attack. The pain of myocardial in-farction was disappeared after morphine therapy but occurred again and was deteriorated during the apnea of OSAS set-up. The second patient,during AMI being developed,showed repeatedly high sino-atrial,atrio-ventricular block,sinus bradycar-dia and cardiac arrest (max.3.5 s) in the apnea of OSAS attack needing to implant pacemaker.The last,with AMI admit-ted to the hospital,malignant and fatal arrhythmia was triggered off by the middle-end of the longer apnea, which could not be completely controlled by anti-arrhythmia drugs and electrical defibrillation. These characteristics of OAS in AMI must be paid more attention to till now in clinical cardiology.