| 摘要: |
| 摘 要 目的 应用超声心动图技术评价阻塞性睡眠呼吸暂停综合征（OSAS）患者肺动脉僵硬度（PAS）与心室重构的关系。方法 经多导睡眠呼吸仪（PSG）监测呼吸暂停低通气指数（AHI）≥5次/h确诊为OSAS的患者137例，次日晨行血压、血糖、血脂及超声心动图检查，依据左室质量指数（LVMI）和相对室壁厚度（RWT）分为4组：正常构型（NG）组，向心性重构（CR）组，离心性肥厚（EH）组，向心性肥厚（CH）组。同时选取健康志愿者35例作为对照组。采集左心室、右心室和PAS相关参数，比较组间差异，对PAS和右室参数进行相关性分析，并对PAS的相关危险因素进行回归分析。结果 ①与对照组比较，OSAS 各组PAS增加（均P＜0.05）；与NG组比较，CR组和EH组PAS增加（均P＜0.05）；与NG组、CR组、EH组比较，CH组PAS增加（均P＜0.05）。②OSAS患者PAS与右心室参数的相关性分析显示PAS与Et/At呈负相关（r=-0.376，P＜0.05），与右室内径（r=0.363，P＜0.05）、Tei指数（r=0.366，P＜0.05）、mPAP（r=0.631，P＜0.05）呈正相关。③PAS与临床、睡眠和超声心动图参数的相关性分析显示PAS与年龄（r=0.154，P＜0.05）、体质指数（r=0.166，P＜0.05）、收缩压（r=0.253，P＜0.05）、舒张压（r=0.153，P＜0.05）、AHI（r=0.336，P＜0.05）、LVMI（r=0.276，P＜0.05）、RWT（r=0.286，P＜0.05）、左室几何构型（r=0.433，P＜0.05）呈正相关，与Lowest Sa02（r=-0.158，P＜0.05）呈负相关。④多元线性回归分析显示PAS与年龄（t=2.426，P＜0.05）、AHI（t=2.477，P＜0.05）、左室几何构型（CR：t=2.422；EH：t=2.334；CH：t=3.101，均P＜0.05）独立相关。结论 OSAS不同左室构型患者PAS变化情况不同，PAS与异常左室几何构型独立相关，说明PAS与心室重构过程相关。 |
| 关键词: 超声心动描记术 睡眠呼吸暂停，阻塞性 肺动脉僵硬度 心室重构 左室构型 |
| DOI： |
| 投稿时间：2021-03-23修订日期：2021-05-16 |
| 基金项目: |
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| Clinical study of echocardiography in evaluating the relationship between pulmonary artery stiffness and ventricular remodeling in patients with obstructive sleep apnea syndrome |
| tianyun,shui wen,wang jian,zhang yong,feng xiaoli,kang caihong,cui tong |
| () |
| Abstract: |
| ABSTRACT Objective Echocardiography was used to evaluate the relationship between pulmonary artery stiffness (PAS) and ventricular remodeling in patients with obstructive sleep apnea syndrome (OSAS). Methods A total of one hundred and thirty-seven patients with OSAS diagnosed by polysomnography (PSG) with apnea hypopnea index (AHI)≥5/h were enrolled. Blood pressure and general clinical characteristics were collected and echocardiography was performed next morning. On the basis of left ventricular mass index (LVMI) and relative wall thickness (RWT), patients were divided into 4 groups: normal geometry (NG), concentric remodeling (CR), eccentric hypertrophy (EH), concentric hypertrophy (CH). At the same time, 35 healthy volunteers were selected as the control group. Parameters related to left ventricle, right ventricle and PAS were collected, and the differences between groups were compared. Correlation analysis was conducted for PAS and right ventricular parameters, and regression analysis was conducted for the risk factors related with PAS. Results ①Compared with control group, PAS increased in each OSAS group (all P<0.05). Compared with NG group, PAS increased in CR and EH group (all P<0.05). Compared with NG, CR and EH group, PAS increased in CH group (all P<0.05). ② Correlation analysis between PAS and right ventricular parameters in patients with OSAS showed that PAS was negatively correlated with Et/At (r=-0.376, P<0.05), and positively correlated with right ventricular diameter(r=0.363, P<0.05), Tei index (r=0.366, P<0.05) and mPAP (r=0.631, P<0.05). ③Correlation analysis of PAS with clinical, sleep and echocardiographic parameters showed that PAS was positively correlated with age (r=0.154, P<0.05), body?mass?index?(r=0.166, P<0.05), systolic blood pressure (r=0.253, P<0.05), diastolic blood pressure (r=0.153, P<0.05), AHI (r=0.336, P<0.05), LVMI (r=0.276, P<0.05), RWT (r=0.286, P<0.05), left ventricular geometry (r=0.433, P<0.05), and positively correlated with Lowest Sa02 (r=-0.158, P<0.05). ④Multiple linear regression analysis showed that PAS was independently correlated with age (t=2.426, P<0.05), AHI (t=2.477, P<0.05), left ventricular geometry (CR: t=2.422; EH: t=2.334; CH: t=3.101, all P<0.05). Conclusions The changes of PAS in OSAS patients with different left ventricular geometry are different, PAS is independently related to abnormal left ventricular geometry, suggesting that PAS is related to the process of ventricular remodeling. |
| Key words: Echocardiography Sleep apnea, obstructive pulmonary artery stiffness ventricular remodeling left ventricular geometry |
