摘要
目的分析阻塞性睡眠呼吸暂停患者的临床资料,探讨阻塞性睡眠呼吸暂停患者代谢及睡眠相关参数与左心室肥厚的关系。方法分析兰州大学第一医院2023年9月-2024年8月96例确诊为阻塞性睡眠呼吸暂停的患者,根据彩色多普勒超声心动图检查结果,按左心室质量指数(LVMI)将阻塞性睡眠呼吸暂停患者分为LVH组和非LVH组。根据电子病历获取所有患者的一般临床资料、检验结果、超声心动图参数及睡眠相关参数,采用SPSS 26.0进行统计分析。结果LVH组患者的收缩压比非LVH组高,HGB比非LVH组低,LVH组女性占比高于非LVH组(P均<0.05);LVH组患者的左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室重量(LVM)、LVMI比非LVH组高(P均<0.05);LVH组患者的最高血氧饱和度、最低血氧饱和度及平均血氧饱和度低于非LVH组,90%以内的氧减次数高于非LVH组(P均<0.05);与LVMI的偏相关性分析显示收缩压(r=0.319,P<0.05),同型半胱氨酸(HCY)(r=0.288,P<0.05)呈正相关,最低血氧饱和度(r=-0.225,P<0.05)、平均血氧饱和度(r=-0.255,P<0.05)呈负相关,与LVEDD的偏相关性分析显示HCY(r=0.306,P<0.05)呈正相关,与IVST的偏相关性分析显示收缩压(r=0.270,P<0.05)、HCY(r=0.219,P<0.05)呈正相关,与LVPWT的偏相关性分析显示HCY(r=0.250,P<0.05)呈正相关;收缩压和中重度阻塞性睡眠呼吸暂停为OSA患者发生LVH的危险因素(P<0.05),且二者独立影响OSA患者LVH的发生。结论在OSA患者中,收缩压、HCY及间歇性缺氧相关指标与左心室重构相关,收缩压和中重度阻塞性睡眠呼吸暂停为OSA患者发生LVH的危险因素。
Objective To analyze the clinical data of patients with obstructive sleep apnea,so as to explore the relationship between metabolic and sleep-related parameters and left ventricular hypertrophy in OSA patients.Methods A total of 96 patients diagnosed with obstructive sleep apnea from the First Hospital of Lanzhou University from September 2023 to August 2024 were analyzed.According to the results of color Doppler echocardiography,they were divided into the obstructive sleep apnea patients group with and without LVH group according to the left ventricular mass index(LVMI).Their general clinical data,test results,echocardiographic parameters and sleep-related parameters of all patients were obtained according to electronic medical records,and statistical analysis was performed by SPSS26.0.Results The systolic blood pressure and hemoglobin(HGB)in the LVH group were higher than those in the non-LVH group,and the proportion of female in the LVH group was higher than those in the non-LVH group(all P<0.05).LVEDD,IVST,LVPWT,LVM and LVMI in the LVH group were higher than those in the non-LVH group(all P<0.05).The maximum oxygen saturation,minimum oxygen saturation and average oxygen saturation in the LVH group were lower than those in the non-LVH group,and the frequency of oxygen reduction within 90%was higher than that in the non-LVH group(all P<0.05).Partial correlation analysis with LVMI showed a positive correlation with systolic blood pressure(r=0.319,P<0.05)and homocysteine(HCY)(r=0.288,P<0.05),and a negative correlation with minimum blood oxygen saturation(r=-0.225,P<0.05)and mean blood oxygen saturation(r=-0.255,P<0.05).Partial correlation analysis with LVEDD showed a positive correlation with HCY(r=-0.306,P<0.05).Partial correlation analysis with IVST showed a positive correlation with systolic blood pressure(r=0.270,P<0.05)and HCY(r=0.219,P<0.05).Partial correlation analysis with LVPWT showed that HCY(r=0.250,P<0.05)was positively correlated.Systolic blood pressure and moderate-to-severe obstructive sleep apnea were risk factors for LVH in OSA patients(P<0.05),and they independently affected LVH occurrence in OSA patients.Conclusion Systolic blood pressure,HCY,and intermittent hypoxia are associated with left ventricular remodeling in patients with obstructive sleep apnea.Systolic blood pressure and moderate-to-severe obstructive sleep apnea are risk factors for LVH in OSA patients.
作者
马媛媛
岳红梅
秦亚茹
陈东津
田凤
MA Yuanyuan;YUE Hongmei;QIN Yaru;CHEN Dongjin;TIAN Feng(the First Clinical Medical College of Lanzhou University,Lanzhou,Gansu 730000,China;Department of Respiratory and Critical Care Medicine,the First Hospital of Lanzhou University,Lanzhou,Gansu 730000,China)
出处
《临床肺科杂志》
2025年第8期1142-1149,共8页
Journal of Clinical Pulmonary Medicine
基金
甘肃省科技计划(科技重大专项计划)(22ZD1FA001)。
关键词
阻塞性睡眠呼吸暂停
左心室肥厚
收缩压
平均血氧饱和度
最低血氧饱和度
同型半胱氨酸
obstructive sleep apnea
left ventricular hypertrophy
systolic blood pressure
mean blood oxygen saturation
minimum blood oxygen saturation
homocysteine
作者简介
通信作者:岳红梅,E-mail:yuehongmei18@sina.com。
