老年男性阻塞性睡眠呼吸暂停与心血管疾病危险因素的相关性
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Relationship Between Obstructive Sleep Apnea Syndrome and Cardiovascular Risk Factors in the Male Elderly
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    摘要:

    目的观察老年男性阻塞性睡眠呼吸暂停综合征与心血管疾病危险因素的相关性。方法采用多导睡眠仪对老年男性582例进行监测并明确有无阻塞性睡眠呼吸暂停,同时测定受试者体质指数、颈围、腰围、臀围、血压、血脂、空腹血糖和高敏C反应蛋白水平。根据多导睡眠仪监测得出的呼吸暂停低通气指数,将研究对象分为阻塞性睡眠呼吸暂停综合征组和对照组,阻塞性睡眠呼吸暂停综合征组又根据呼吸暂停低通气指数的高低分为重度、中度及轻度阻塞性睡眠呼吸暂停综合征组,观察阻塞性睡眠呼吸暂停综合征对上述冠心病危险因素的影响。结果阻塞性睡眠呼吸暂停综合征组体重指数、颈围、臀围、腰围、收缩压、空腹血糖、高敏C反应蛋白、甘油三酯较对照组明显升高(P<0.05);高密度脂蛋白胆固醇、最低脉搏容积血氧饱和度、平均脉搏容积血氧饱和度较对照组明显降低(P<0.05);阻塞性睡眠呼吸暂停综合征组合并代谢综合征人数较对照组明显增多;重度阻塞性睡眠呼吸暂停综合征组体重指数、颈围、腰围、臀围较轻、中度组明显增高(均P<0.001);重度组高密度脂蛋白胆固醇、最低脉搏容积血氧饱和度、平均脉搏容积血氧饱和度较中度组明显降低(P<0.05);Spearm an’s相关分析显示,阻塞性睡眠呼吸暂停综合征呼吸暂停低通气指数与体重指数、颈围、臀围、腰围、收缩压、空腹血糖、高敏C反应蛋白成明显正相关,与高密度脂蛋白胆固醇成明显负相关;Stepw ise回归分析显示,颈围与阻塞性睡眠呼吸暂停综合征独立相关。结论在老年男性,阻塞性睡眠呼吸暂停综合征与心血管疾病危险因素密切相关,这可能是阻塞性睡眠呼吸暂停综合征增加心血管疾病发生率和死亡率的主要原因。

    Abstract:

    Aim To study the association between obstructive sleep apnea syndrome(OSAS) and cardiovascular risk factors in the male elderly. Methods 582 male elderly subjects were recruited and underwent standard polysomnography(PSG).Body mass index(BMI),neck circumference,waist circumference,hip circumference,waist to hip ratio,blood pressure,fasting blood glucose(FBS),high sensitivity C-reactive protein(hs-CRP),total cholesterol(TC),high density lipoprotein cholesterol(HDLC),triglyceride(TG),low density lipoprotein cholesterol(LDLC),free fatty acids(FFA) were measured.With respect to apnea-hypopnea index(AHI),the subjects were divided into OSAS patients and controls,furthermore,according to the value of AHI,OSAS patients were classified into mild,moderate and severe OSAS ones. Results OSAS patients had higher BMI,neck circumference,waist circumference,hip circumference,systolic blood pressure,FBS,hs-CRP,TG than controls.HDLC,average oxyhemoglobin saturation and minimum oxyhemoglobin saturation during sleep time was lower in OSAS patients than controls.The prevalence of metabolic syndrome was higher in OSAS patients than in controls.Severe OSAS patients had higher BMI,neck circumference,waist circumference,hip circumference,average and minimum oxyhemoglobin saturation during sleep time,however lower HDLC than mild and moderate patients.In Spearman's correlate analysis,OSAS and AHI were positively correlated with BMI,neck circumference,waist circumference,hip circumference,systolic blood pressure,FBS,hs-CRP and inversely correlated with HDLC.In multiple stepwise regression analysis,neck circumference was independently correlated with OSAS.Conclusion OSAS in the male elderly is associated with cardiovascular risk factors,which maybe induce the increased morbidity and mortality of cardiovascular disease.

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.长沙血液中心, 湖南省长沙市 ; .中南大学湘雅二医院老年病科,湖南省长沙市 .老年男性阻塞性睡眠呼吸暂停与心血管疾病危险因素的相关性[J].中国动脉硬化杂志,2011,19(10):851~855.

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  • 收稿日期:2011-05-13
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