阻塞性睡眠呼吸暂停低通气综合征与冠脉慢血流现象的相关性分析

发布时间：2018-02-16 16:57

本文关键词： 冠脉慢血流现象睡眠呼吸暂停呼吸紊乱指数氧减指数　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]本研究通过比较阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome) 患者与冠脉慢血流现象(coronary slow flow phenomenon,CSFP)患者的一般资料、生化指标及冠脉造影后记录的左前降支帧数、校正左前降支(left anterior descending,LAD)帧数、左回旋支帧数、右冠脉帧数、校正后平均冠脉血流帧数,睡眠监测后的呼吸紊乱指数、最低血氧饱和度、氧减指数,探讨睡眠呼吸暂停与冠脉慢血流现象之间相关性。[方法]收集2016年1月-2017年2月入住昆明医科大学第二附属医院心内科胸痛患者146例,记录患者一般资料,包括性别、年龄、体重、身高、BMI、腰围、臀围、空腹血糖(fasting blood glucose, FBG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model insulin resistance index,HOMA-IR)、纤维蛋白原、总胆固醇(Total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-c)、低密度脂蛋白胆固醇(Low density lipoprotein-cholesterol,LDL-c)、血小板、平均血小板体积(mean platelet volume,MPV)、C 反应蛋白(C reactive protein,CRP)。所有患者均行冠脉造影,并记录LAD帧数、校正LAD帧数、左回旋支帧数(left circumflex branch,LCX )、右冠脉(Right coronary branch , RCA)帧数、平均冠脉血流帧数(mean TIMI frame counts,mean TFC),分为冠脉慢血流组和非冠脉慢血流组。非冠脉慢血流组为随机选取同期冠脉造影患者。再行多导睡眠监测,记录AHI、ODI、LSPO2,比较冠脉慢血流组和非冠脉慢血流组的OSAHS发病率。再将冠脉慢血流患者分为OSAHS组和非OSAHS组,统计分析阐明冠脉慢血流与OSAHS的关系。计量资料符合正态分布采用均数±标准差(x±s)表示,两组间差异分析用t检验。计数资料用率或构成比表示,如性别、高血压、糖尿病,吸烟两组间差异采用卡方检验。采用多因素Logistic回归分析冠脉慢血流的危险因素。[结果]1.冠脉慢血流组OSAHS发病率较非冠脉慢血流组高(45.8% : 14% )。2. OSAHS 组患者的 LCX 帧数(30.45±4.92)、RCA 帧数(38.88±2.10)、mean TFC(30.85 ±1.90)较非 OSAHS 组高(21. 31±2. 6, 35. 42±6.18 ,25.15±1.18 )(P0.05)。3.以AHI、LSAO2、ODI为自变量,mean TFC为因变量,进行逐步回归分析,发现 AHI (r=0.87, p0.01)、ODI (r=0.851,p0.01)与 mean TFC成正相关,LSAO2与mean TFC成负相关(r=-0.82,p0.01)。[结论]冠脉慢血流现象与AHI、ODI呈显著正相关,与LSA02呈显著负相关,OSAHS促进了冠脉慢血流现象的发生与发展。
[Abstract]:[objective] to compare the general data, biochemical indexes and the number of frames of left anterior descending branch in patients with obstructive sleep apnea-hypopnea syndrome and coronary slow flow phenomenon flow in patients with obstructive sleep apnea hypopnea syndrome (OSAS). The number of left anterior descending lad frames, the left circumflex branch frames, the right coronary artery frames, the average coronary blood flow frame number, the respiratory disturbance index after sleep monitoring, the lowest oxygen saturation, the oxygen desaturation index, the left anterior descending branch frame number, the right coronary artery frame number, the sleep monitoring respiratory disturbance index, the lowest oxygen saturation, the oxygen desaturation index, To investigate the correlation between sleep apnea and slow coronary flow. [methods] A total of 146 patients with chest pain in Department of Cardiology, second affiliated Hospital of Kunming Medical University, from January 2016 to February 2017, were collected and their general data, including sex and age, were recorded. Weight, height, waist circumference, hip circumference, fasting blood glucose, FBG, fasting insulin, fasting insulin, insulin resistance index, homeostasis model insulin resistance index-HOMA-IRN, fibrinogen. Total cholesterol cholesterol total cholesterol total cholesterol, triglyceride triglyceride, high density lipoprotein cholesterol high density protein-cholesterol HDL-cn, low density lipoprotein cholesterol low density protein-cholesterol, platelet, mean platelet volume, MPVV-C-reactive protein C reactive protein, all patients underwent coronary angiography and recorded LAD frames, Corrected LAD frames, left circumflex branchs, right coronary branches, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs, RCAs. The mean TIMI frame count was divided into two groups: slow coronary flow group and non-coronary slow flow group. The non-coronary slow flow group was randomly selected for simultaneous coronary angiography, and polysomnography was performed. The incidence of OSAHS was compared between slow coronary flow group and non-coronary slow flow group. Patients with slow coronary flow were divided into OSAHS group and non-#en2# group. Statistical analysis was used to clarify the relationship between coronary slow flow and OSAHS. The mean 卤standard deviation x 卤s was used to measure the normal distribution, and t test was used to analyze the difference between the two groups. The rate or composition ratio of the counting data, such as sex, hypertension, diabetes mellitus, were used to calculate the difference between the two groups, such as sex, hypertension, diabetes mellitus. Smoking difference between the two groups was chi-square test. Multivariate Logistic regression analysis was used to analyze the risk factors of coronary slow flow. [results] 1. The incidence of OSAHS in the slow coronary flow group was 45.8% higher than that in the non-coronary slow flow group. The LCX frame number of the patients in the OSAHS group was higher than that in the non-coronary slow flow group. The mean TFC(30.85 卤1.90 (38.88 卤2.10 TFC(30.85 卤1.90) was higher than that in the non-#en1# group (21.31 卤2.6,3542 卤6.18 卤25.15 卤1.18). By stepwise regression analysis, it was found that there was a positive correlation between AHI TFC and mean TFC. [conclusion] there was a significant positive correlation between slow coronary flow and mean TFC. [conclusion] there was a significant positive correlation between slow coronary flow and mean TFC, and there was a negative correlation between LSAO 2 and mean TFC. [conclusion] there is a significant positive correlation between slow coronary flow and mean TFC, and the correlation between LSAO 2 and mean TFC is negative. [conclusion] there is a significant positive correlation between coronary slow flow and mean TFC. There was a significant negative correlation with LSA02. OSAHS promoted the occurrence and development of slow coronary flow.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766;R541.4

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