阻塞性睡眠呼吸暂停综合征患者夜间心律失常的发病特点及行为干预疗效

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者夜间心律失常的发病特点以及行为干预疗效。方法:393例鼾症患者根据睡眠多导图分为单纯鼾症组(216例)和OSAS组(177例),根据患者的个体情况进行行为干预(包括戒烟、少酒、纠正仰卧睡姿、增加运动、合理饮食等),随访一年后,比较干预前后最低氧饱和度(minSaO 2)、氧饱和度小于90%的时间(TSaO 2)、呼吸暂停低通气指数(AHI)及心律失常发生率等。结果:与干预前比较,干预后OSAS组minSaO 2(75.9±4.8)%比(82.1±5.0)%]显著增加,TSaO 2(28.3±7.6)min比(23.5±6.4)min]、AHI(17.3±8.3)次/h比(14.8±6.6)次/h]显著下降,且均显著优于单纯鼾症组(P均<0.01);鼾症组上述指标均无显著变化(P均>0.05)。干预前,OSAS组心律失常发生率显著高于鼾症组(59.9%比22.2%,P=0.001),干预后OSAS组心律失常发生率较干预前显著下降(28.2%比59.9%,P=0.001),但仍显著高于鼾症组(19.4%,P=0.04)。结论:OSAS患者心律失常的发生率高,临床应予足够重视。行为干预可减少OSAS患者心律失常的发生。

Onset characteristics of nighttime arrhythmia in patients with obstructive sleep apnea syndrome and therapeutic effect of behavioral intervention

Objective:To explore onset characteristics of nighttime arrhythmia in patients with obstructive sleep apnea syndrome(OSAS)and therapeutic effect of behavioral intervention.Methods:According to polysomnographic map,a total of 393 patients with snoring disease were divided into pure snoring group(n=216)and OSAS group(n=177).Behavioral intervention,including quitting smoking,alcohol limitation,supine sleeping position correction,increasing exercise and reasonable diet etc,were performed according to individual situation of patients.After on-year follow-up,minimum saturation of blood oxygen(minSaO 2),SaO 2<90%time(TSaO 2),apnea hypopnea index(AHI)before and after intervention,and incidence rate of arrhythmias were compared between two groups.Results:Compared with before intervention,there was significant rise in minSaO 2(75.9±4.8)%vs.(82.1±5.0)%],and significant reduction in TSaO 2(28.3±7.6)min vs.(23.5±6.4)min]and AHI(17.3±8.3)times/h vs.(14.8±6.6)times/h]in OSAS group after intervention,and were significantly superior to those of pure snoring group,P<0.01 all;there were no significant changes in above indexes in snoring group after intervention,P>0.05 all.Before intervention,incidence rate of arrhythmia in OSAS group was significantly higher than that of snoring group(59.9%vs.22.2%,P=0.001);after intervention,incidence rate of arrhythmia in OSAS group was significantly lower than that of before intervention(28.2%vs.59.9%,P=0.001),but still significantly higher than that of snoring group(19.4%,P=0.040).Conclusion:Incidence rate of arrhythmia is high in OSAS patients,which calls for enough attention in clinic.Behavioral intervention can reduce incidence of arrhythmia in OSAS patients.