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目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与心律失常的关系及经鼻持续正压通气(nCPAP)治疗OSAS所致心律失常的疗效。方法:对82例睡眠打鼾者同步进行夜间7h以上多导睡眠图(PSG)及24h动态心电图监测,根据PSG结果分为OSAS组64例和对照组(单纯鼾症组)18例,比较组间最长呼吸暂停时间(LAT)、平均呼吸暂停时间(MAT)、呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(mSaO2)、心律失常发生率及发生类型;对18例中重度OSAS伴心律失常患者行nCPAP治疗,比较治疗前后监测资料。结果:OSAS组LAT、MAT长于对照组,AHI高于对照组,mSaO2低于对照组(均P<0.01),OSAS组心律失常发生率显著高于对照组(P<0.01);并且随着病情加重而升高(P<0.05)。nCPAP治疗后,AHI下降,mSaO2上升,平均每小时心律失常发生次数较治疗前显著减少(均P<0.01)。结论:OSAS与心律失常之间存在显著相关性,OS-AS患者夜间心律失常与低氧血症密切相关,nCPAP可有效减少心律失常的发生。
Objective: To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and cardiac arrhythmia and the efficacy of nasal continuous positive pressure ventilation (nCPAP) in the treatment of arrhythmia induced by OSAS. Methods: Eighty-two sleep snorers were monitored for polysomnography (PSG) at 7h and 24-hour Holter monitoring simultaneously. According to PSG results, 64 patients were divided into two groups: OSAS group (64 cases) and control group (snoring group) LAT, MAT, AHI, mSaO2, the incidence of arrhythmia and the type of arrhythmia were observed in 18 patients with moderate to severe OSAS Patients with arrhythmia underwent nCPAP treatment and compared the data before and after treatment. Results: LAT and MAT in OSAS group were longer than those in control group, AHI was higher than that in control group, mSaO2 was lower than that in control group (all P <0.01), incidence of arrhythmia in OSAS group was significantly higher than that in control group (P <0.01) Increased and increased (P <0.05). After nCPAP treatment, AHI decreased, mSaO2 increased, the average number of arrhythmia per hour was significantly lower than before treatment (all P <0.01). Conclusion: There is a significant correlation between OSAS and arrhythmia. Nocturnal arrhythmia in patients with OS-AS is closely related to hypoxemia, and nCPAP can effectively reduce arrhythmia.