阻塞性睡眠呼吸暂停低通气综合征与冠状动脉慢血流现象的关系

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)与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的相关性。方法收集胸痛患者146例,根据冠状动脉心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)血流帧数(TIMI flame counts,TFC)分为CSFP组和非CSFP组,比较两组的OSAHS发病率。再根据睡眠监测将冠状动脉慢血流患者分为OSAHS亚组和非OSAHS亚组,分析CSFP与OSAHS的相关性。结果 CSFP组OSAHS发病率较非CSFP组高,差异有统计学意义(45.8%vs. 14.0%,P0.05)。OSAHS亚组患者的左回旋支(left circumflex coronary artery,LCX)帧数、右冠状动脉(right coronary artery,RCA)帧数、平均TFC较非OSAHS亚组高,差异有统计学意义(30.45±4.92 vs. 21.31±2.6;38.88±2.10 vs. 31.42±6.18;30.85±1.90 vs. 22.15±1.18,P0.05)。以睡眠呼吸暂停低通气指数(apnea hypop-nea index,AHI)、氧减指数(oxygen desaturation index,ODI)、最低血氧饱和度(the lowest oxygen saturation,LSPO_2)为自变量,平均TFC为因变量进行相关分析,发现平均TFC与AHI(r=0.87,P0.01)、ODI(r=0.85,P0.01)呈正相关,与LSAO_2呈负相关(r=-0.82,P0.01)。结论 CSFP与AHI、ODI呈显著正相关,与LSAO_2呈显著负相关,提示OSAHS促进了CSFP的发生与发展。