摘要
目的：本研究分别在肥胖和非肥胖人群中分析比较阻塞性睡眠呼吸暂停（OSA）对急性冠脉综合征（ACS）患者临床特点的影响。方法：2015年12月至2017年12月在北京安贞医院前瞻性连续纳入ACS患者，对符合入排标准的患者行便携式睡眠呼吸监测检查。在肥胖人群（BMI≥28 kg/m2）中根据睡眠呼吸暂停低通气指数（apnea-hypopnea index，AHI）将患者分为OSA组（AHI≥15）和非OSA组（AHI＜15），比较两组患者的一般临床特征、实验室检查、睡眠呼吸监测等结果。在非肥胖人群（BMI＜28 kg/m2）中根据AHI将患者分为OSA组（AHI≥15）和非OSA组（AHI＜15），比较两组的患者一般临床特征、实验室检查、睡眠呼吸监测等结果。结果：研究共纳入837例ACS患者：肥胖患者292例，其中OSA患者199例（68%）；非肥胖患者545例，其中OSA患者233例（43%）。在非肥胖人群中，OSA组患者年龄大于非OSA组（59.74±9.85 vs. 57.66±9.7, p=0.014） , OSA组的中性粒细胞（6.06±2.78 vs. 5.52±2.71, p=0.023）、hs-CRP（8.54±10.57vs. 5.84±9.27, p=0.002）、血糖（7.05±2.66 vs. 6.54±2.29, p=0.021）、多支病变比例高于非OSA组，左心射血分数低于非OSA组（58.12±8.63vs.59.71±8.09,p=0.042）。肥胖人群中以上情况未见统计学差异。结论：在非肥胖的ACS患者中，OSA组的炎症严重程度、血糖水平、多支病变比例高于非OSA组，左心射血分数低于非OSA组。在肥胖的ACS患者中，两组的炎症反应、血糖水平、血管病变情况等未见统计学差异。
Objective： This study aims to analyze the effect of obstructive sleep apnea （OSA） on the clinical characteristics of obese and non-obese patients with acute coronary syndrome. Methods： Patients with acute coronary syndrome were prospectively admitted to Beijing Anzhen Hospital, Capital Medical University from Dec. 2015 to Dec.2017.Patients who met the inclusion criteria were examined with portable sleep respiration monitor. Patients were divided into OSA group （AHI ≥ 15） and non-OSA group （AHI〈15） according to the sleep apnea-hypopnea index （AHI） in obese people （BMI ≥ 28 kg/m2）,the consequence of clinical features, laboratory tests and sleep respiration monitor were compared among the two groups. Patients were divided into OSA group （AHI ≥ 15） and non-OSA group （AHI〈15） according to AHI in non-obese people （BMI〈28 kg/m2）,the consequence of clinical features, laboratory tests and sleep respiration monitor were compared among the two groups. Results： A total of 837 patients with ACS were enrolled in this study. Patients with AHI≥15 accounts for 51.6%.There were 292 obese patients, including 199 patients with moderate/severe OSA （68%） and 545 non-obese patients, including 233 patients （43%） with moderate/severe OSA. In non-obese people ,The OSA group was older than non-OSA group （59.74 ± 9.85 vs. 57.66 ± 9.7, p = 0.014）, the level of neutrophil （6.06 ± 2.78 vs. 5.52 ± 2.71, p = 0.023）, hs-CRP （8.54 ± 10.57 vs. 5.84 ± 9.27, p = 0.002）, blood glucose （7.05 ± 2.66 vs. 6.54 ± 2.29 , p = 0.021）, the proportion of multi-vessel disease was higher than those of non-OSA group. Above is no statistical difference in obesity. Conclusion： In non-obese patients with ACS, the severity of inflammation, blood glucose level and the proportion of multi-vessel disease in OSA group were higher than those in non-OSA group and the left ventricular ejection fraction was lower than that in non-OSA group. In obese patients with ACS, there was no significant statistical difference in the inflammatory response, blood glucose level, and vascular disease between the two groups.
作者
石涵
范婧尧
王晓
郝问
赵冠棋
周生辉
李奥博
郭芮丰
李泽萱
聂绍平
魏永祥
Sill Han;FAN Jing-yao;WANG Xiao(Emergency ＆ Critical Care Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《中国心血管病研究》
CAS
2018年第9期787-792,共6页
Chinese Journal of Cardiovascular Research
基金
国家国际科技合作专项(项目编号:2015DFA30160)
国家自然科学基金青年项目(项目编号:81600209)
北京市医管局重点医学发展计划(项目编号:ZYLX201710)
北京市医院管理局“青苗”计划(项目编号:QML20160605)
首都医科大学基础临床科研合作课题(项目编号:16JL17)
