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目的评估血清C-反应蛋白(CRP)的浓度、左房大小和房性早搏与睡眠呼吸暂停综合症(OSAS)的关系。方法经多导睡眠呼吸监测诊断为OSAS的277名患者行24 h动态心电图和动态血压检查。将发现有房性早搏的137名患者根据呼吸暂停低通气指数(AHI)分成3组,即轻度组(5≤AHI<15),中度组(15≤AHI<30)和重度组(AHI≥30)。比较3组患者的血清CRP浓度、左房直径,分析二者与OSAS严重程度之间的关系。结果 OSAS患者中,房性早搏的发生率较高,为49.4%(134/277)。轻、中、重度OSAS患者的CRP值分别为(2.98±1.82)mg/L,(3.03±1.94)mg/L,(5.01±4.68)mg/L,左房直径分别为(33.7±3.8)mm,(37.9±5.5)mm,(40.1±7.9)mm。血清CRP水平和左房直径与OSAS的严重程度成正相关(r=0.304,P=0.034;r=0.411,P=0.003)。在排除性别、年龄和体质量指数的影响下,CRP和左房直径也呈正相关(r=0.594,P=0.0005)。结论 OSAS患者房性早搏的发病率较高。在这些患有房性早搏的OSAS患者中,CRP水平和左房直径的大小与OSAS的严重程度成正相关的关系,提示炎症激活介导的左房重构和电重构可能在OSAS患者房性早搏的发生中起重要作用。
Objective To evaluate the relationship between serum C-reactive protein (CRP) concentration, left atrium size and atrial premature beats and sleep apnea syndrome (OSAS). Methods A total of 277 OSAS patients diagnosed by polysomnography were enrolled in 24-hour ambulatory ECG and ambulatory blood pressure examination. 137 patients with atrial premature beats were divided into 3 groups based on apnea hypopnea index (AHI): mild (5 ≤ AHI <15), moderate (15 ≤ AHI <30), and severe ≥30). Serum CRP concentration and left atrial diameter were compared between the three groups, and the relationship between them and the severity of OSAS was analyzed. Results Among OSAS patients, the incidence of atrial premature beats was higher (49.4%, 134/277). The CRP of mild, moderate and severe OSAS patients were (2.98 ± 1.82) mg / L, (3.03 ± 1.94) mg / L and (5.01 ± 4.68) mg / L, , (37.9 ± 5.5) mm, (40.1 ± 7.9) mm. Serum CRP levels and left atrial diameter were positively correlated with the severity of OSAS (r = 0.304, P = 0.034; r = 0.411, P = 0.003). There was also a positive correlation between CRP and left atrium diameter (r = 0.594, P = 0.0005), excluding gender, age and body mass index. Conclusion The incidence of atrial premature beats in OSAS patients is high. In these OSAS patients with atrial premature beats, the relationship between the level of CRP and the size of the left atrium is positively related to the severity of OSAS, suggesting that inflammation activation-mediated left atrial remodeling and electrical remodeling may be atrial OSAS Premature beats play an important role.