体位性睡眠呼吸暂停综合征患者睡眠呼吸紊乱及心率变异性的特点

摘要

Objective To investigate the characteristics of HRV parameters in different posture of patients with positional obstructive sleep apnea syndrome (POSAS) and the relationship between apnea hypopnea index (AHI),minimum oxygen saturation (LSaO2) and HRV parameters.Methods A case-control study was conducted to compare the characteristics of heart rate variability between supine and lateral positions in POSAS patients.Results Compared with lateral position,POSAS group showed higher levels of heart rate variability indexes (P ＜ 0.05).Pearson correlation analysis indicated that AHI was positively correlated with SDNN、SDANN、ULF、LF/HF (P ＜ 0.05 or P ＜ 0.01).Remarkably,the correlation between AHI and LF/HF was excellent (r =0.437,P ＜ 0.01),and negatively correlated with HF(r =-0.306,P ＜ 0.05).Similarly,LSaO2 was negatively correlated with LF/HF.Conclusion The sleep-disordered breathing in supine position of POSAS patients is significantly heavier than that in lateral decubitus position.%目的 探讨体位性睡眠呼吸暂停综合征(POSAS)患者不同体位下HRV参数的特点及呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)与HRV各参数的关系.方法 采用病例对照方法比较POSAS患者仰卧位和侧卧位的心率变异性的特点.结果 与侧卧位相比,POSAS组患者仰卧位时的心率变异性指标显著增加(P＜0.05).Pearson相关分析结果显示,AHI与SDNN、SDANN、ULF、LF/HF参数呈正相关(P＜0.05或P＜0.01),其中AHI与LF/HF相关性最强(r=0.437,P＜0.01),而与HF呈负相关(r=-0.306,P＜0.05);LSaO2与LF/HF呈负相关(r=-0.388,P＜0.01).结论 POSAS患者仰卧位睡眠呼吸紊乱显著重于侧卧位.