超声评价睡眠呼吸暂停综合征患者左心室构型对睡眠质量的影响及其与颈动脉结构和功能的相关性(1)
摘要 目的：針对超声评价睡眠呼吸暂停综合征(OSAS)患者左心室构型对睡眠质量的影响及其与颈动脉结构和功能的相关性观察。方法：选取2016年5月至2017年5月在菏泽市中医医院就诊的睡眠呼吸暂停综合征患者96例作为研究对象。按照左心室构型分为正常构型(1组)、向心性重构(2组)、向心性肥厚(3组)、离心性肥厚(4组)4组。比较4组患者心脏参数及睡眠质量。包括：左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVSd)、左心射血分散(LVEF)、相对室壁厚度(RWT)、左心室质量指数(LVMI)及颈动脉脉结构和功能参数：内径(D)、内径变化幅度(Dis)、颈动脉局部内中膜厚度(IMT)、顺应性(CC)、扩张性(DC)、脉搏波传导速度(PWV)差异性，睡眠质量：PSQI及ESS评分，分析患者左室构型参数同颈动脉结构和功能参数相关性。结果：同1比较，2组的IMT、PWV、PSQI、ESS评分有所提升，3组D、IMT、PWV、PSQI、ESS评分有所升高，4组D、Dis、IMT、CC、PWV、PSQI、ESS评分也有所升高；与2组比较，3组D、IMT、PWV、PSQI、ESS评分有所升高，4组D、Dis、IMT、CC、PWV、PSQI、ESS评分有所升高；与1组比较，2组RWT、LVDd、LVSd、PSQI、ESS评分上升，3组LVMI、LVDd、LVSd上升，LVEF下降，4组LVMI、RWT、LVSd、LVDd、PSQI、ESS评分上升，LVEF下降，以上比较差异均有统计学意义(P<0.05)；与2组比较，3组LVMI、LVDd、PSQI、ESS评分上升，RWT、LVEF下降。4组LVMI、LVDd、LVSd、PSQI、ESS评分上升，以上比较差异均有统计学意义(P<0.05)。经过分析显示，OSAS患者左心室构型参数LVMI与IMT、PWV之间程正相比关系。结论：OSAS能够引起左室异常重构反应以及造成颈动脉结构和功能损害，影响患者睡眠质量，且日间会出现嗜睡，其中左室肥厚OSAS患者颈动脉结构和功能伤害最大，睡眠障碍及日间嗜睡程度最重，左室构型与颈动脉结构和功能具有正相比相关性。
关键词 睡眠呼吸暂停综合征；超声评价；左心室构型；颈动脉；睡眠质量；日间嗜睡；相关性
中图分类号：R338.63文献标识码：Adoi：10.3969/j.issn.2095-7130.2018.09.036
Abstract Objective：To evaluate The effect of left ventricular configuration on sleep quality in patients with sleep apnea syndrome(SASO)and its correlation with carotid structure and function were evaluated by ultrasound.Methods：A Total of 96 patients with sleep apnea syndrome who were admitted to our hospital from May 2016 to May 2017 were selected as subjects of the observation group.it was divided into four groups of normal configuration(group 1)，centripetal reconstruction(group 2)，centripetal hypertrophy(group 3)and centrifugal hypertrophy(group 4).Cardiac parameters and sleep quality of the four groups were compared.Including：left ventricular diastole(LVDd)，left ventricular contraction(LVSd)，left ventricular ejection dispersion(LVEF)，relative ventricular wall thickness(RWT)，and left ventricular mass index(LVMI).The differences in the structure and functional parameters of the carotid pulse，such as the internal diameter(D)，the change range of the internal diameter(Dis)，the local medial membrane thickness of the carotid artery(IMT)，the compliance(CC)，the dilation(DC)，and the pulse wave conduction velocity(PWV)and sleep quality：PSQI and ESS scores，were analyzed，the correlation between left ventricular configuration parameters and carotid structure and functional parameters was analyzed.Results：Compared with 1，IMT，PWV，PSQI and ESS scores of the 2 groups increased，while D，IMT，PWV，PSQI and ESS scores of the 3 groups increased，D，Dis，IMT，CC，PWV，PSQI and ESS scores of the 4 groups also increased.compared with group 2，D，IMT，PWV，PSQI and ESS scores of the 3 groups increased，and D，Dis，IMT，CC，PWV，PSQI and ESS scores of the 4 groups increased； compared with the group 1，RWT，LVDd，LVSd，PSQI and ESS scores of the group 2 increased，LVMI，LVDd and LVSd of the group 3 increased，LVEF decreased，LVMI，RWT，LVSd，LVDd，PSQI and ESS scores of the group 4 increased，and LVEF decreased，compared with the group 2，LVMI，LVDd，PSQI and ESS scores of the group 3 increased，while RWT and LVEF scores decreased.LVMI，LVDd，LVSd，PSQI and ESS scores of the group 4 increased，and the above comparisons were significantly different and statistically significant(P<0.05).Analysis showed that the left ventricular configuration parameters of OSAS patients were positively correlated with LVMI，IMT and PWV.Conclusion：OSAS can cause abnormal left ventricular remodeling reaction and damage carotid artery structure and function，affects patients′ sleep quality，and can appear daytime sleepiness，left ventricular hypertrophy of OSAS patients with carotid artery structure and function damage is the largest of damage，has heaviest degree of sleep disorders and daytime sleepiness，the left ventricular configuration is positively correlated with the structure and function of carotid artery., http://www.100md.com(王俊梅)
关键词 睡眠呼吸暂停综合征；超声评价；左心室构型；颈动脉；睡眠质量；日间嗜睡；相关性
中图分类号：R338.63文献标识码：Adoi：10.3969/j.issn.2095-7130.2018.09.036
Abstract Objective：To evaluate The effect of left ventricular configuration on sleep quality in patients with sleep apnea syndrome(SASO)and its correlation with carotid structure and function were evaluated by ultrasound.Methods：A Total of 96 patients with sleep apnea syndrome who were admitted to our hospital from May 2016 to May 2017 were selected as subjects of the observation group.it was divided into four groups of normal configuration(group 1)，centripetal reconstruction(group 2)，centripetal hypertrophy(group 3)and centrifugal hypertrophy(group 4).Cardiac parameters and sleep quality of the four groups were compared.Including：left ventricular diastole(LVDd)，left ventricular contraction(LVSd)，left ventricular ejection dispersion(LVEF)，relative ventricular wall thickness(RWT)，and left ventricular mass index(LVMI).The differences in the structure and functional parameters of the carotid pulse，such as the internal diameter(D)，the change range of the internal diameter(Dis)，the local medial membrane thickness of the carotid artery(IMT)，the compliance(CC)，the dilation(DC)，and the pulse wave conduction velocity(PWV)and sleep quality：PSQI and ESS scores，were analyzed，the correlation between left ventricular configuration parameters and carotid structure and functional parameters was analyzed.Results：Compared with 1，IMT，PWV，PSQI and ESS scores of the 2 groups increased，while D，IMT，PWV，PSQI and ESS scores of the 3 groups increased，D，Dis，IMT，CC，PWV，PSQI and ESS scores of the 4 groups also increased.compared with group 2，D，IMT，PWV，PSQI and ESS scores of the 3 groups increased，and D，Dis，IMT，CC，PWV，PSQI and ESS scores of the 4 groups increased； compared with the group 1，RWT，LVDd，LVSd，PSQI and ESS scores of the group 2 increased，LVMI，LVDd and LVSd of the group 3 increased，LVEF decreased，LVMI，RWT，LVSd，LVDd，PSQI and ESS scores of the group 4 increased，and LVEF decreased，compared with the group 2，LVMI，LVDd，PSQI and ESS scores of the group 3 increased，while RWT and LVEF scores decreased.LVMI，LVDd，LVSd，PSQI and ESS scores of the group 4 increased，and the above comparisons were significantly different and statistically significant(P<0.05).Analysis showed that the left ventricular configuration parameters of OSAS patients were positively correlated with LVMI，IMT and PWV.Conclusion：OSAS can cause abnormal left ventricular remodeling reaction and damage carotid artery structure and function，affects patients′ sleep quality，and can appear daytime sleepiness，left ventricular hypertrophy of OSAS patients with carotid artery structure and function damage is the largest of damage，has heaviest degree of sleep disorders and daytime sleepiness，the left ventricular configuration is positively correlated with the structure and function of carotid artery., http://www.100md.com(王俊梅)
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