2018 年第 3 期 第 13 卷

阻塞性睡眠呼吸暂停严重程度与冠状动脉粥样硬化性心脏病患者冠状动脉病变的相关性

Correlation between severity of obstructive sleep apnea and coronary lesions in patients with coronary atherosclerotic heart disease

作者：吴献懿王晓范婧尧聂绍平魏永祥

英文作者：Wu Xianyi Wang Xiao Fan Jingyao Nie Shaoping Wei Yongxiang

单位：100029首都医科大学附属北京安贞医院急诊危重症中心（吴献懿、王晓、范婧尧、聂绍平），耳鼻咽喉头颈外科中心（魏永祥）

英文单位：Emergency and Critical Care Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China（Wu XY Wang X Fan JY Nie SP）; Otolaryngology Head and Neck Surgery Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China（Wei YX）

关键词：冠状动脉疾病；阻塞性睡眠呼吸暂停低通气综合征；定量冠状动脉造影

英文关键词：Coronaryheartdisease;Obstructivesleepapneahypopneasyndrome;Quantitativecoronaryangiography

• 摘要：

• 目的    分析阻塞性睡眠呼吸暂停（OSA）严重程度与冠状动脉粥样硬化性心脏病（冠心病）患者冠状动脉病变的相关性。方法    连续入选2016年5—8月首都医科大学附属北京安贞医院急诊危重症中心收治的冠心病患者140例，所有患者均经冠状动脉造影确诊并接受睡眠呼吸监测，按照睡眠呼吸暂停低通气指数（AHI）分为无和轻度OSA组（59例，AHI≤15次/h）与中重度OSA组（81例，AHI＞15次/h）。对2组患者使用目测法、SYNTAX评分、定量冠状动脉造影（QCA）法3种方法，对冠状动脉病变进行评估。结果    中重度OSA组多支血管病变比例高于无和轻度OSA组［80.2%（65/81）比59.3%（35/59）］，差异有统计学意义（P＜0.01）。中重度OSA组SYNTAX评分高于无和轻度OSA组［（21±10）分比（17±12）分］，差异有统计学意义(P＜0.05)。结论    与无和轻度OSA患者相比，中重度OSA患者的冠状动脉病变更为复杂，分布更广泛。

  【基金项目】国家自然科学基金（81600209）；国家国际科技合作专项（2015DFA30160）；北京市科技计划（Z141100006014057）；北京市优秀人才培养资助项目

• 【Abstract】Objective    To analyze the correlation between severity of obstructive sleep apnea(OSA) and coronary artery lesions in patients with coronary atherosclerotic heart disease（CHD）. Methods    A total of 140 patients with CHD were enrolled from May 2016 to August 2016 in Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University. All patients received coronary angiography and polysomno-graphy, and they were divided into non/mild OSA group［59 cases, apnea hypopnea index(AHI)≤15 times/h］ and moderate/severe OSA group(81 cases, AHI＞15 times/h). Coronary lesions were analyzed by visual observation, the SYNTAX score and quantitative coronary angiography. Results    Ratio of multivessel lesions in moderate/severe OSA group was significantly higher than that in non/mild OSA group［80.2%（65/81） vs 59.3%（35/59）］（P＜0.01）. The SYNTAX score in moderate/severe OSA group was significantly higher than that in non/mild OSA group［（21±10）points vs （17±12）points］(P＜0.05). Conclusion    Compared with patients without OSA or with mild OSA, coronary artery disease in patients with moderate to severe OSA is more complex and widely distributed.

  【Fund program】National Natural Science Foundation of China（81600209）； National International Science and Technology Cooperation Project（2015DFA30160）； Beijing Science and Technology Project（Z141100006014057）； Beijing Talent Training Funded Project（2016000021469G194）； Scientific Research Cultivation Project of Beijing Municipal Administration of Hospitals（PX2016048）； "Qingmiao" Young Talent Training Project of Beijing Municipal Administration of Hospitals（QML20160605）