老年冠心病患者阻塞性睡眠呼吸暂停低通气综合征与病死率关系的研究

目的探讨在老年冠心病患者中阻塞性睡眠呼吸暂停低通气综合征（0SAHS）对其病死率的影响。方法根据多导睡眠图结果和是否接受经鼻持续气道正压通气（CPAP）将132例合并中-重度OSAHS的老年冠心病患者分成OSAHS未治疗组（观察组，n=97）；OSAHs接受CPAP治疗组（治疗组,n=35），另将70例无0sAHs的老年冠心病患者设为对照组。结果跟踪观察4年，所有观察者中有22例患者死于心血管原因、中风以及冠状动脉重建。根据Cox回归模型分析，经过CPAP治疗的OSAHS患者病死率要明显低于未治疗OSAHS者，而且与对照组比较无显著差异。在校正了年龄因素影响后，未接受CPAP治疗的老年冠心病患者较对照组病死率显著增高。结论与未合并OSAHS的老年冠心病患者相比，合并OSAHS且未接受CPAP治疗的患者呈现较高的病死率，而经CPAP治疗的合并OSAHS患者其病死率与普通老年冠心病患者无显著差异。

The mortality of elderly coronary heart disease patients combined with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the effects of obstructive sleep apnea hypopnea syndrome （OSAHS） on the mortality among the elderly with coronary heart disease （CHD）. Methods Based on the polysomnographyic results and whether nasal continuous positive airway pressure （CPAP） treatment was performed or not, 132 elderly with both CHD and moderate-to-severe OSAHS were divided into non-treatment group （observation group, n =97） and treatment group （n =35）. In addition, 70 elderly with CHD but without OSAHS were recruited as control group. Results By the end of 4 years follow-up, 22 patients died of cardiovascular events, stroke and coronary artery reconstruction. According to Cox regression analysis, the mortality in treatment group was significantly lower than that in observation group, but was not significantly different from that in control group. After adjusting age and body mass index, the mortality in observation group was still significantly higher than that in control group. Conclusion Among the elderly CHD patients, those with coexisting OSAHS have a significantly higher mortality than those without OSAHS. However, once CPAP treatment is performed in the elderly with both CHD and OSAHS, the mortality of the treatment group shows no significant difference from that of the patients without OSAHS.