冠状动脉粥样硬化性心脏病合并阻塞性睡眠呼吸暂停低通气综合征患者的临床特征

目的 了解冠状动脉粥样硬化性心脏病(coronary artery disease,CAD)患者中阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的患病率,并探讨其临床特征.方法 对2007年8月至2008年8月因胸痛、胸闷等类似心绞痛症状入住我院心脏中心行冠状动脉造影(coronary angiography,CAG)的患者进行多导睡眠图(polysomnography,PSG)监测,并分析CAD合并OSAHS患者的临床特征.结果 入选患者310例,合并OSAHS患者220例(70.97%).经CAG确诊CAD患者231例(74.52%),合并OSAHS患者168例(72.73%);CAG阴性患者79例,合并OSAHS患者52例(65.82%).CAD合并OSAHS患者与CAD不合并OSAHS患者之间颈围、腰臀比、夜间胸痛发作、嗜睡指数、夜间憋醒、夜尿增多、反酸、晨起口干、体质量指数均有显著差异.Logistic回归分析显示夜间胸痛、夜尿增多、晨起口干和肥胖是CAD合并OSAHS患者的重要危险因素.结论 以类似心绞痛症状就诊的患者中OSAHS的患病率高,尤其CAG阳性的患者;伴有夜间憋醒或胸痛、夜尿增多、晨起口干及肥胖的CAD患者要常规排查OSAHS.

Clinical features of patients with coronary artery disease and obstructive sleep apnea-hypopnea syndrome

Objective To investgate the prevalence rate of obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with coronary artery disease(CAD) ,and to assess the clinical features of patients with OSAHS and CAD. Methods Polysomnography(PSG) monitoring was performed in all patients undergoing coronary angiography(CAG) from August 2007 to August 2008 in the Cardiovascular Disease Center of Beijing Chaoyang Hospital. The clinical features were recorded and analyzed. Results Angiography and PSG monitoring were performed in 310 consecutive inpatients. 231 patients were diagnosed as having CAD. There were 168 (72.73%) patients of the CAD patients who had OSAHS. Among the patients whose coronary angiography were negative, there were 52 (65.82%) patients who had OSAHS. There were significant differences of neck circumference, waist hip ratio, the frequences of nocturnal angina, nocturnal pilyuria, throat thirsty in the morning,and higher BMI between two groups. Logistic regression analysis showed that the frequences of nocturnal angina, nocturnal pilyuria, throat thristy in the morning and higher BMI were significant risk factors of the patients with CAD and OSAHS. Conclusions There is a high prevalence rate of OSAHS in patients with CAD,and PSG monitoring should be performed in patients with CAD,especially for patients with clinical features such as frequent nocturnal angina, nocturnal pilyuria, throat thirsty in the morning,and higher BMI.