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目的初步探讨重度阻塞性睡眠呼吸暂停综合征(OSAS)与窦房结功能障碍(SD)间的关系。方法分析2005年3月至2006年6月我院睡眠实验室确诊的所有重度 OSAS 患者70例及单纯鼾症患者36例的多导睡眠监测中的心电图变化。对最低心率<40次/min 或最高窦性心率<90次/min 或最长 R-R 间期>2.0 s 者在超微心电图(UMECG)监测下行阿托品试验,以观察和比较他们的窦房结功能,并分析 SD 的危险因素。以 SPSS13.0软件包处理数据。结果 SD 在重度 OSAS 患者中占22.9%;在单纯鼾症者中占5.6%,差异有统计学意义(P=0.025)。经 Logistic 回归法分析提示睡眠期最低脉氧饱和度的降低是发生 SD 的一个主要危险因素(P=0.003,OR<0.001,95%CI0.000～0.016)。结论重度 OSAS 患者 SD 的发生率高于鼾症者。睡眠期最低脉氧饱和度降低为重度 OSAS 患者发生 SD 的一个主要危险因素。
Objective To investigate the relationship between severe obstructive sleep apnea syndrome (OSAS) and sinus node dysfunction (SD). Methods From March 2005 to June 2006, 70 patients with severe OSAS diagnosed in our hospital sleep laboratory and 36 patients with simple snore were monitored for polysomnography. The atropine test was performed on the ultramicroscopic electrocardiogram (UMECG) for the lowest heart rate <40 beats / min or the highest sinus heart rate <90 beats / min or the longest RR interval> 2.0 s to observe and compare their sinus node function , And analyze the risk factors of SD. Processing data with SPSS13.0 software package. Results SD accounted for 22.9% of patients with severe OSAS and 5.6% of patients with simple snore, the difference was statistically significant (P = 0.025). Logistic regression analysis showed that the lowest sleep oxygen saturation was the main risk factor of SD (P = 0.003, OR <0.001, 95% CI0.000 ~ 0.016). Conclusion The incidence of SD in severe OSAS patients is higher than snorers. The lowest sleep oxygen saturation is a major risk factor for SD in patients with severe OSAS.