摘要
目的 观察鼾症老年人中睡眠呼吸暂停症 (SAS)与部分心血管异常改变的相关性及经鼻持续气道正压通气(nCPAP)对SAS的有关疗效。方法 采用多导睡眠仪将 6 7例 6 0岁以上老年鼾症者分为SAS组和非SAS组 ,同时通过Holter心电及血压检测仪就两组间血压昼夜节律、高血压、心率变异性、部分心律失常、冠心病的状况作出比较。在SAS组中将接受nCPAP治疗 5～ 7d后的以上有关心血管状况与治疗前加以比较。结果 鼾症老人中SAS的发病率较高 (47.8% ) ;在SAS组中 ,高血压、血压昼夜节律消失、冠心病心绞痛对扩冠药疗效不佳、睡眠期心率变异性降低、心律失常及动脉血氧饱和度 (SaO2 )降低的发生率均明显高于非SAS组。经nCPAP治疗后睡眠期不仅鼾声消除、SaO2 明显增高和呼吸暂停 /低通气指数明显降低 ;而且心率变异性 (HRV)和血压昼夜节律恢复。结论 SAS在老年心血管疾病的发生和发展上有着不可忽视的相关性 ,应用nCPAP不仅对SAS有较满意的疗效 ,而且对改善其并存的心血管病变也有重要的作用。
Objectives To investigate the association between sleep apnea syndrome(SAS) and some cardiovascular abnormalities in elderly snorers and the effectiveness of nasal continuous positive airway pressure (nCPAP) in those with SAS.Methods With the use of polysomnography,67 elderly snorers (older than 60 yrs) were examined and divided into SAS and non SAS groups.Meanwhile,with continuous Holter EKG and blood pressure (Bp) measurement,the day to night rhythm of Bp,hypertension,heart rate variability (HRV),some arrhythmia and coronary atherosclerosis disease (CAD) were compared between two groups as well as before and after nCPAP treatment for 5～7 days in SAS group. Results The incidence of SAS was high (48%) in the elderly snorers.There were significantly higher incidences of hypertension,disapearance of day to night rhythm of Bp,poor effectiveness of nitrate on angina pectoris of CAD,decreased HRV during sleep,arrhythmia and declined SaO 2 in SAS group than in non SAS group.After nCPAP treatment control of snoring,significant increase in SaO 2 and decrease in index of apnea/hypopnea during sleep were achieved;HRV and day to night rhythm of Bp recovered. Conclusions The results suggest that there is a close association between the development of SAS and some cardiovascular diseases and nCPAP is effective not only on SAS but also on coexisting cardiovascular disorders.
出处
《中华老年心脑血管病杂志》
CAS
2001年第3期150-152,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
