阻塞性睡眠呼吸暂停低通气综合征患者颈动脉内膜中膜厚度与左心结构功能的相关性研究

doi:10.3969/j.issn.1007-3205.2024.04.005

摘要/Abstract

摘要： 目的分析阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者左心结构功能变化及其与颈动脉内膜中膜厚度（carotid intima-media thickness，CIMT）相关性。
方法选取OSAHS患者90例，根据呼吸暂停低通气指数分为轻度组28例，中度组36例，重度组26例。比较3组一般资料、左心结构功能指标［左心室收缩末期内径(left ventricular end-systolic diameter，LVESD）、左室舒张末期内径(left ventricular end-diastolic diameter(LVEDD)、左心室后壁厚度（left ventricular posterior wall thickness，LVPWT）、室间隔厚度（interventricular septal thickness，IVST）、左心室质量指数（left ventricular mass index，LVMI）、左心室射血分数（left ventricular ejection fractions，LVEF）、E峰减速时间（eject decel time，EDT）］以及颈动脉功能指标［肺动脉内径（pulmonary artery，PA）、主动脉内径（aortic diameter，AO）、扩张性（dilatancy，DC）、顺应性（compliance，CC）、内径变化幅度（distension，Dis）］及CIMT。分析OSAHS患者颈动脉CIMT与左心结构功能变化的相关性。
结果 3组性别、年龄、病程、心率、舒张压以及收缩压差异无统计学意义（P＞0.05），中度组和重度组体重指数（body mass index，BMI）高于轻度组，重度组BMI高于中度组，差异有统计学意义（P＜0.05）；中度组和重度组LVESD、LVEDD、LVPWT、IVST、LVMI、A峰以及EDT均明显高于轻度组，LVEF、E峰、E/A均明显低于轻度组，重度组LVESD、LVEDD、LVPWT、IVST、LVMI、A峰以及EDT均明显高于中度组，LVEF、E峰、E/A均明显低于中度组（P＜0.05）；中度组和重度组PA、AO、DC、CC、Dis、IMT均明显高于轻度组，重度组PA、AO、DC、CC、Dis、CIMT均明显高于轻度组（P＜0.05）。OSAHS患者颈动脉CIMT与左心结构功能LVESD、LVEDD、LVPWT、IVST、LVMI指标呈明显正相关（r=0.334、0.318、0.416、0.316、0.438，P＜0.05），与LVEF呈明显负相关（r=-0.356，P＜0.05）。
结论 OSAHS患者的左心结构功能及颈动脉CIMT随着病情的加重会发生明显变化，且两者存在显著相关性，可为防治OSAHS患者出现心血管疾病提供依据。

关键词: 睡眠呼吸暂停, 阻塞性, 颈动脉内膜中膜厚度, 心室功能, 左

Abstract: Objective To analyze changes in left heart structure and function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its correlation with carotid intima-media thickness (CIMT).
Methods A total of 90 patients with OSAHS were divided into mild group (n=28), moderate group (n=36) and severe group (n=26) according to the apnea hypopnea index. The general data, left ventricular structure and function indexes ［left ventricular end-systolic diameter (LVESD）, left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness （LVPWT）, interventricular septal thickness （IVST）,left ventricular mass index（LVMI）,left ventricular ejection fractions （LVEF）， eject decel time （EDT）］ and carotid artery function indexes ［pulmonary artery (PA), aortic diameter (AO), dilatancy (DC), compliance (CC), distension (Dis)］ and CIMT were compared among the three groups. The correlation between carotid CIMT and left ventricular structure and function in OSAHS patients was analyzed.
Results There were no significant differences in sex, age, course of disease, heart rate, diastolic blood pressure and systolic blood pressure among the three groups (P＞0.05). Body mass index (BMI) in moderate and severe groups was higher than that of mild group, and higher in severe group than in moderate group, and the difference was statistically significant (P＜0.05). LVESD, LVEDD, LVPWT, IVST, LVMI, peak A and EDT in moderate and severe group were significantly higher than those in mild group, while LVEF, peak E and E/A were significantly low than those in mild group; LVESD, LVEDD, LVPWT, IVST, LVMI, peak A and EDT in severe group were significantly higher than those in moderate group, while LVEF, peak E and E/A were significantly lower than those in moderate group (P＜0.05). PA, AO, DC, CC, Dis and IMT in moderate and severe group were significantly higher than those in mild group, and PA, AO, DC, CC, Dis and CIMT in severe group were significantly high than those in mild group (P＜0.05). The carotid CIMT was positively correlated with left ventricular structure and function indexes LVESD, LVEDD, LVPWT, IVST and LVMI respectively (r=0.334, 0.318, 0.416, 0.316, 0.438, P＜0.05), and negatively correlated with LVEF (r=-0.356, P＜0.05).
Conclusion The left heart structure and function and carotid CIMT of OSAHS patients will change obviously with the aggravation of the disease, and there is a significant correlation between them, which can provide evidence for the prevention and treatment of cardiovascular diseases in OSAHS patients.

Key words: sleep apnea, obstructive, carotid intima-media thickness, ventricular function, left

张智斌, 谢允平, 陈幸榕, 杨晓玲. 阻塞性睡眠呼吸暂停低通气综合征患者颈动脉内膜中膜厚度与左心结构功能的相关性研究 [J]. 河北医科大学学报, 2024, 45(4): 395-399.

ZHANG Zhi-bin, XIE Yun-ping, CHEN Xing-rong, YANG Xiao-ling. The correlation between carotid intima-media thickness and left cardiac structure in patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Hebei Medical University, 2024, 45(4): 395-399.

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阻塞性睡眠呼吸暂停低通气综合征患者颈动脉内膜中膜厚度与左心结构功能的相关性研究

The correlation between carotid intima-media thickness and left cardiac structure in patients with obstructive sleep apnea hypopnea syndrome

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