老年人阻塞性睡眠呼吸暂停综合征与冠心病关系的探讨

目的　探讨老年冠心病患者睡眠呼吸障碍的发生情况及其与胰岛素抵抗的关系。方法　应用多导睡眠监护仪对4 8例老年冠心病患者进行监测。以呼吸紊乱指数(AHI) 15作为界值,共有2 2例诊断为阻塞性睡眠呼吸暂停综合征(OSAS) ,将其分为冠心病组和冠心病合并OSAS组。进行睡眠监测时同时行2 4h动态心电图检查。结果　冠心病合并OSAS组与对照组比较,AHI为(39.6±12 .3) ,该组有着更低的血氧饱和度和胰岛素敏感指数。而且该组患者夜间发生ST段压低例数明显多于对照组。结论　老年冠心病患者合并OSAS夜间出现心肌缺血的发生率高,与严重的夜间低氧血症有关,并且存在着明显的胰岛素抵抗。

Relation between senile obstructive sleeping apnea syndrome and coronary heart disease

Objective To analyse the pathogenic relation between senile obstructive sleeping apnea syndrome(OSAS) and coronary heart disease(CHD).Methods Forty-eight elderly patients with coronary heart disease were monitored by polyguidance sleeping graph(PSG).Apnea hypopnea index (AHI) of 15 was used as cutoff value and the patients were divided into 2 groups.Group I(n=26) had an hourly rate of apnea and hypopnea of 15 episodes.Group Ⅱ (n=22)had an index of more than 15 episodes per hour.Results In group Ⅱ,AHI varied from 26.3 to 51.9(39.6±12.3) episodes per hour.Group Ⅱ had more ischemic attacks and lower minimal arterial oxyhemoglobin saturation during sleep.Conclusion The sleep disordered breathing episodes are associated with severe nocturnal arterial blood oxyhemoglobin desaturation,and this can worsen insulin resistance.