冠心病患者冠状动脉病变程度与睡眠呼吸暂停综合征相关性分析

敖明强 朱汀 陈君

[摘要] 目的 探讨冠心病患者冠状动脉病变严重程度与睡眠呼吸暂停综合征的相关性。 方法 对我院2019年3—10月行冠状动脉造影明确诊断为冠心病的78例患者行睡眠监测检查，根据睡眠呼吸监测结果分为无睡眠呼吸暂停综合征组（正常组）、轻度睡眠呼吸暂停综合征组（轻度组）、中重度睡眠呼吸暂停综合征组（中重度组），比较三组患者一般情况、睡眠呼吸暂停指数及Gensini评分情况，并分析AHI和Gensini评分的相关性。 结果 三组患者年龄、性别、身高、体重、吸烟、饮酒、合并高血压、糖尿病情况比较，差异无统计学意义（P>0.05）。中重度组Gensini评分、AHI高于轻度组和正常组，轻度组高于正常组，差异有统计学意义（P<0.05）。在正常组中，AHI和Gensini评分无相关性;在轻度组中，AHI和Gensini评分呈轻度相关;在中重度组中，AHI和Gensini评分呈中度相关。 结论 冠心病患者中睡眠呼吸暂停程度越严重冠状动脉病变程度越严重。

[关键词] 冠心病;睡眠呼吸暂停综合征;睡眠监测;Gensini评分

[Abstract] Objective To investigate the correlation between the severity of coronary artery disease and sleep apnea syndrome in patients with coronary heart disease. Methods Seventy-eight patients who were diagnosed with coronary heart disease by coronary angiography in our hospital from March to October 2019 underwent sleep monitoring examination. According to the results of sleep breathing monitoring， they were divided into non-sleep apnea syndrome group （the normal group）， mild sleep apnea syndrome group（mild group） and moderate to severe sleep apnea syndrome group（moderate to severe group）. The general conditions， sleep apnea index and the Gensini score of the three groups were compared. And the correlation between AHI and Gensini score was analyzed. Results There was no significant difference in age， gender， height， body weight， smoking， drinking， complicated with hypertension and diabetes among the three groups（P>0.05）. Gensini scores and AHI of coronary artery disease in moderate and severe group were higher than those in mild sleep group and normal group， and those in mild sleep group were higher than those in normal group， the differences were statistically significant（P<0.05）. In the normal group， AHI and Gensini scores were not correlated; in the mild group， AHI and Gensini scores were slightly correlated; in the moderate and severe group， AHI and Gensini scores were moderately correlated. Conclusion The more severe the degree of sleep apnea in patients with coronary heart disease， the more severe the degree of coronary artery disease.

[Key words] Coronary heart disease; Sleep apnea syndrome; Sleep monitoring; Gesini score

冠狀动脉粥样硬化性心脏病（Coronary heart disease，CHD）（简称冠心病）的发生发展与多种因素有关，近年来不少研究发现睡眠呼吸暂停综合征（Obstructive sleep apnea hypopnea syndrome，OSAHS）与冠心病的发生有密切关系，与高血压、糖尿病等一样，OSAHS已被证实为冠心病的另一个重要危险因素，能促进动脉粥样硬化的发展[1]。有研究显示，OSAHS患者冠状动脉病变的狭窄程度比非OSAHS患者更严重，OSAHS患者更易发生多支病变，但有关冠心病患者冠状动脉病变程度与OSAHS相关性的研究较少，本研究通过对冠心病患者睡眠呼吸暂停严重程度进行分析，探究冠心病患者冠脉病变程度与OSAHS的相关性，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年3—10月在我院行冠状动脉造影检查明确诊断冠心病的患者78例，纳入标准[12]：18～75岁，NYHA心功能分级Ⅰ～Ⅱ级，有独立完整认知能力者。排除……