中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

阻塞性睡眠呼吸暂停低通气综合征与主动脉夹层关系的相关研究

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目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome,OSAHS)与主动脉夹层(aortic dissection, AD)的关系。 方法 选择 2016 年 1 月至 2018 年 1 月于我院经血管 CTA 确诊的 53 例 AD 患者。采用 STOP-BANG 问卷表对所有入组 AD 患者进行评分,评分≥3 者经手术或保守治疗病情稳定后均接受多导睡眠监测(polysomnography,PSG),根据睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)是否≥5 将 53 例患者分为 OSAHS 组与非 OSAHS 组。 结果 OSAHS 组纳入 18 例患者[男 17 例,女 1 例,年龄(43.3±8.4)岁],非 OSAHS 组纳入 35 例患者[男 23 例,女 12 例,年龄(56.6±12.9)岁]。在主动脉夹层 Stanford 分型、发病时间、个人史、糖尿病史、冠心病史、高脂血症病史以及经治后睡前血压等方面,两组数据未见明显差异(P>0.05);OSAHS 组患者年龄明显小于非 OSAHS 组(P<0.01);OSAHS 组患者男/女比例(P=0.021)、体重(P<0.01)、身高(P=0.028)、体重指数(BMI)(P<0.01)以及经治后醒后收缩压和舒张压(P=0.028,P=0.044)明显比非 OSAHS 组高,OSAHS 组既往高血压患者比例明显高于非 OSAHS 组(P=0.042);其差异均有统计学意义。 结论 AD 合并 OSAHS 者多为男性,且年轻、高胖体型者明显多于非 OSAHS 组;OSAHS 可能为年轻男性且合并高胖体型 AD 患者发病的危险因素之一。

Objective To explore the Relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and aortic dissection (AD). Methods 53 cases of AD diagnosed by CTA in our hospital from January 2016 to January 2018 were selected; all the patients with AD were scored by the STOP-BANG questionnaire, The patients who scored more than or equal to 3 received polysomnography (PSG) after surgical or conservative treatment, and according to whether the sleep apnea hypopnea index was greater than or equal to 5, 53 patients were divided into an OSAHS group and a non OSAHS group. Results There were 18 patients with 17 males and 1 female at average age of 43.3±8.4 years in the OSAHS group, and 35 patients with 23 males and 12 females at average age of 56.6±12.9 years. There were no significant difference between the two groups in the Stanford classification of aortic dissection, the time of onset, personal history, the history of diabetes, coronary heart disease and hyperlipidemia, post-treatment systolic/diastolic blood pressure before sleep (P>0.05). The age of patients in the OSAHS group was significantly less than that in the non OSAHS group (P<0.01), the proportion of men/women (P=0.021), weight (P<0.01), height (P=0.028), body mass index (P<0.01), and post-treatment systolic/diastolic blood pressure after waking up (P=0.044) in the OSAHS group were significantly higher than those in the non OSAHS group. In the OSAHS group, the proportion of previous hypertension was significantly higher than that in the non OSAHS group (P=0.042). Conclusion AD patients combined with OSAHS are mostly in male patients. The number of young and high-fat people are significantly more than that in the non OSAHS group. OSAHS may be one of the risk factors for young, high-fat men with AD.

关键词: 阻塞性睡眠呼吸暂停低通气综合征; 主动脉夹层; 高血压

Key words: Obstructive sleep apnea and hypopnea syndrome; aortic dissection; hypertension

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