心衰合并房颤患者睡眠呼吸暂停综合征的发生情况及临床特征

发布时间：2018-03-04 10:16

本文选题：睡眠呼吸暂停综合征　切入点：心房颤动　出处：《南京医科大学》2016年博士论文　论文类型：学位论文

【摘要】：背景和目的心力衰竭、睡眠呼吸障碍疾病和心律失常之间的关系复杂,而且关于这方面的报道不多。本研究分析心衰合并心房颤动(房颤)患者睡眠呼吸暂停综合征(SAS)的发生情况及临床特征。材料和方法对2012年6月至2014年6月期间在南京医科大学第一附属医院住院的心衰患者进行心电图筛选出110例房颤患者(合并房颤组),同时将年龄、性别、体质指数相匹配的105例无房颤的单纯心衰患者(单纯心衰组)作为平行对照,对比观察及分析两组患者SAS的发病情况及特征。结果两组在心衰病因、合并症、NYHA分级、基础用药方面差异均无统计学意义。合并房颤组白日Epworth嗜睡量表评分和心胸比均显著高于单纯心衰组[(10.1±5.8)比(8.2±5.5)分和0.63±0.08比0.57±0.07,均P0.05],而6 min步行距离显著短于单纯心衰组[(305+70)比(335+69)m,P0.05]。两组患者左室射血分数、左室舒张末内径、左室收缩末内径差异均无统计学意义,而合并房颤组左房内径显著大于单纯心衰组(P0.05)。合并房颤组SAS发生比例显著高于单纯心衰组(36.4%比20.0%,P0.05),睡眠呼吸暂停低通气指数也显著高于单纯心衰组[4(1,16)比3(1,7)次/h,P0.05],而其他多导睡眠监测指标如快动眼睡眠时间百分比、觉醒指数、平均氧饱和度、最低氧饱和度、氧减指数等差异均无统计学意义(均P0.05)。结论心衰合并房颤患者比单纯心衰患者更易发生SAS,以CSA为主,且白日嗜睡更重,活动能力更差。
[Abstract]:Background and objective the relationship between heart failure, sleep apnea and arrhythmia is complex. In this study, the incidence and clinical characteristics of sleep apnea syndrome (SAS) in patients with heart failure complicated with atrial fibrillation (AF) were analyzed. Materials and methods from June 2012 to June 2014. In the first affiliated Hospital of Nanjing Medical University, 110 patients with atrial fibrillation were selected by electrocardiogram. Sex and body mass index matched 105 patients with simple heart failure without atrial fibrillation (simple heart failure group) as parallel control. The incidence and characteristics of SAS in the two groups were compared and analyzed. The scores of daytime Epworth somnolence scale and cardiothoracic ratio in patients with atrial fibrillation were significantly higher than those in patients with simple heart failure [10.1 卤5.8 vs 8.2 卤5.5, 0.63 卤0.08 vs 0.57 卤0.07, P0.05, respectively], but the walking distance of 6 min was significantly shorter than that of simple heart failure group. [P 0.05]. Left ventricular ejection fraction (LVEF) in both groups, There was no significant difference in left ventricular end-diastolic diameter and left ventricular end-systolic diameter. The incidence of SAS in the group with AF was significantly higher than that in the group with simple heart failure (36.4% vs 20.0%, P 0.05), and the sleep apnea hypopnea index was significantly higher than that in the group with simple heart failure (P < 0.05), but the incidence of SAS was significantly higher than that in the group with simple heart failure (P < 0.05), but the incidence of SAS was significantly higher than that in the group with atrial fibrillation (P < 0.05), and the sleep apnea hypopnea index was significantly higher than that in the group with simple heart failure (P < 0.05). His polysomnography monitoring indicators such as the percentage of fast eye movement sleep time, There was no significant difference in arousal index, mean oxygen saturation, minimum oxygen saturation and oxygen reduction index (all P 0.05). Conclusion patients with heart failure complicated with atrial fibrillation are more likely to develop sass than those with simple heart failure, CSA is the main factor, and daytime sleepiness is more severe. The activity ability is worse.
【学位授予单位】：南京医科大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R541;R766

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