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目的:分析室性期前收缩(VPC)频率及交感活性在患有阻塞性睡眠呼吸暂停综合征(OSAS)的冠心病患者中的意义。方法:125例患有OSAS的冠心病患者,均行多导睡眠图检查,将患者按呼吸暂停低通气指数(AHI)进行分组,睡眠阶段分为清醒组、S1、S2、S34及快速眼球运动时相(REM)。并对患者心率震荡参数进行测量对比。结果:VPC频率受睡眠阶段(清醒期、S2及REM,F=5.8,P<0.01)及AHI(F=8.7,P<0.01)影响;在严重OSAS患者,REM期VPC频率较清醒期为高(P=0.01),相反,中等OSAS患者VPC频率较低,且无睡眠阶段依赖性(P≥0.05)。血氧失饱和持续间期与AHI呈正相关(r2=0.71,P<0.01),且在REM期较非REM期为长(P<0.01),在REM期心率震荡参数TS与血氧失饱和持续间期呈负相关(r2=0.06,P=0.01)。结论:REM期高VPC频率可能是OSAS患者夜间高死亡率的原因之一。
Objective: To analyze the significance of ventricular premature contractions (VPC) frequency and sympathetic activity in patients with obstructive sleep apnea syndrome (OSAS). Methods: A total of 125 patients with coronary heart disease with OSAS underwent polysomnography. Patients were divided into apnea - hypopnea index (AHI) group. The sleep stage was divided into awake group, S1, S2, S34 and rapid eye movement Time phase (REM). The patient’s heart rate turbulence parameters were measured and compared. Results: VPC frequency was affected by sleep stage (awake, S2 and REM, F = 5.8, P <0.01) and AHI (F = 8.7, P <0.01) (P = 0.01). In contrast, patients with moderate OSAS had lower VPC frequency and no sleep-stage dependence (P> 0.05). The duration of oxygen saturation was positively correlated with AHI (r2 = 0.71, P <0.01) and was longer in REM than in non-REM (P <0.01). During the REM, heart rate turbulence parameters TS and oxygen saturation disappeared Interval was negatively correlated (r2 = 0.06, P = 0.01). Conclusions: High VPC frequency at REM may be one of the reasons for the high night-time mortality rate in OSAS.