2min)、全部窦性心搏RR间期的标准差(SDNN)、低频功率(LF)、高频功率(HF)及LF/HF在对照组、轻中度组及重度组间比较差异均具有统计学意义(P<0.05);SDANN、rMSSD、PNN50在重度组与轻中度组、重度组与对照组之间差异具有统计学意义(P<0.05);在OSAHS组中SDNN、LF/HF与AHI、ODI、T90具有相关性(P<0.05),DC值与AHI呈负相关(P<0.05)。结论 HRV指标尤其是LF/HF及DC值对OSAHS的初筛及预后评估有重要意义。","endNoteUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=EndNote&id=111","reference":"[1] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[2] Sharma SK, Vasudev C, Sinha S, et al. Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome[J]. Indian J Med Res, 2006,124(3): 281-290.
[3] Zinchuk AV, Gentry MJ, Concato J, et al. Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches[J]. Sleep Med Rev,2017,35: 113-123.
[4] Nagayoshi M, Punjabi NM, Selvin E, et al. Obstructive sleep apnea and incident type 2 diabetes[J]. Sleep Med, 2016,25: 156-161.
[5] Park DH, Shin CJ, Hong SC, et al. Correlation between the severity of obstructive sleep apnea and heart rate variability indices[J]. Journal of Korean Medical Science, 2008, 23 (2):226-231.
[6] Ewing DJ, Campbell IW, Clarke BF, et al.The natural history of diabetic autonomic neuropathy[J]. The Quarterly Journal of Medicine,1980, 49(193):95-108.
[7] Tascilar E, Yokusoglu M, Dundaroz R, et al. Cardiac autonomic imbalance in children with allergic rhinitis[J]. The Tohoku Journal of Experimental Medicine, 2009, 219(3):187-191.
[8] Guilleminault C, Connolly S, Winkle R, et al. Cyclical variation of the heart rate in sleep apnoea syndrome, mechanisms, and usefulness of 24 h electrocardiography as a screening technique[J]. Lancet, 1984, 8369(1):126-131.
[9] Fletcher E, Miller J, Schaaf J, et al.Urinary catecholamines before and after tracheostomy in patients with obstructive sleep apnea and hypertension[J]. Sleep, 1987, 10(1):35-44.
[10] Marrone O, Riccobono L, Salvaggio A, et al.Catecholamines and blood pressure in obstructive sleep apnea syndrome[J]. Chest Journal, 1993, 103(3):722-725.
[11] Grimm W, Koehler U.Cardiac arrhythmias and sleep-disordered breathing in patients with heart failure[J]. Int J Mol Sci, 2014,15(10): 693-705.
[12] Karasulu L, Dalar L, Sökücü S, et al. Heart rate variability analysis of single-channel electrocardiogram can help to differentiate high-risk patients with obstructive sleep apnea syndrome: a study on diagnostic accuracy[J].Anadolu Kardiyol Derg, 2012, 12: 331-338.
[13] Aydin M, Altin R, Ozeren A, et al. Cardiac autonomic activity inobstructive sleepapnea[J].Tex Heart Inst J,2004,31(2):132.
[14] Mehra R, Stone KL, Varosy PD, et al. Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: outcomes of sleep disorders in older men (MrOS sleep) study[J]. Arch Intern Med, 2009,169 (12): 1147-1155.
[15] 温华之.阻塞性睡眠呼吸暂停综合征患者心律失常的发生与心率变异性分析[C]//中国睡眠研究会.中国睡眠研究会第十一届全国学术年会论文汇编.北京:中国睡眠研究会,2019:1.
[16] Gula LJ, Krahn AD, Skanes A, et al. Heart rate variability in obstructive sleep apnea: a prospective study and frequency-domain analysis[J]. Ann Noninvasive Electrocardiol, 2003, 8: 144-149.","bibtexUrl_cn":"//www.pitakata.com/xuebao/CN/article/getTxtFile.do?fileType=BibTeX&id=111","abstractUrl_en":"http://xuebao.sdfmu.edu.cn/EN/10.3969/j.issn.1004-7115.2021.03.003","qi":"3","id":111,"nian":2021,"bianHao":"1630483672585-1115330064","zuoZheEn_L":"LIU Hong-man, XIANG Bing, GAO Lan, MENG Xiao-wu, DU Zhen-lan","juanUrl_en":"http://xuebao.sdfmu.edu.cn/EN/Y2021","clcIndexList_en":[{"code":"R443","text":""}],"shouCiFaBuRiQi":"2021-09-01","qiShiYe":"172","received":"2020-11-12","qiUrl_cn":"//www.pitakata.com/xuebao/CN/Y2021/V42/I3","lanMu_cn":"论著","pdfSize":"1208","zuoZhe_CN":"刘洪满, 向兵, 高兰, 孟晓武, 杜振兰","risUrl_cn":"//www.pitakata.com/xuebao/CN/article/getTxtFile.do?fileType=Ris&id=111","title_cn":"心率变异性及心率减速力对阻塞性睡眠呼吸暂停低通气综合征预测价值","doi":"10.3969/j.issn.1004-7115.2021.03.003","jieShuYe":"175","keywordList_en":["OSAHS","dynamic electrocardiagraphic (DCG) monitoring","HRV"],"endNoteUrl_cn":"//www.pitakata.com/xuebao/CN/article/getTxtFile.do?fileType=EndNote&id=111","zhaiyao_en":"Objective: To discuss the correlation between heart rate variability(HRV) and deceleration (DC) in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: The subjects of 101 patients with daytime somnolence or night sleep snoring in our hospital were included and were categorized into three groups according to apnea-hypopnea index (AHI): AHI<5 as control group, 5≤AHI≤30 as mild-to-moderate OSAHS group, AHI>30 as severe OSAHS group.Polysomnography (PSG) test and 24-hour dynamic electrocardiagraphic (DCG) monitoring in all patients were done and PSG parameters, HRV index and DC were recorded and analyzed. Results: Statistically significant differences were found in HRV index, such as SDNN, LF, LF and LF/HF and PSG parameters, such as AHI, ODI, T90 and SaO2min in between groups. SDANN, rMSSD and PNN50 results revealed significant difference between control group, mild-to-moderate OSAHS group and severe OSAHS group.In the OSAHS group, SDNN and LF/HF were positively linked to AHI, ODI and T90 while DC and AHI were negatively related. Conclusion: HRV index especially LF/HF and DC are important for assessing the prognosis and detecting OSAHS.","bibtexUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=BibTeX&id=111","abstractUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/10.3969/j.issn.1004-7115.2021.03.003","zuoZheCn_L":"刘洪满, 向兵, 高兰, 孟晓武, 杜振兰","juanUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/Y2021","lanMu_en":"","clcIndexList_cn":[{"code":"R443","text":""}],"qiUrl_en":"http://xuebao.sdfmu.edu.cn/EN/Y2021/V42/I3","zuoZhe_EN":"LIU Hong-man, XIANG Bing, GAO Lan, MENG Xiao-wu, DU Zhen-lan","risUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=Ris&id=111","title_en":"The value of heart rate variability and heart rate deceleration in predicting obstructive sleep apnea hypopnea syndrome","hasPdf":"true"},"authorNotes_cn":["刘洪满,主治医师,硕士,主要从事心率变异性与睡眠呼吸暂停相关性研究工作,E-mail:502713654@qq.com。"],"authorList_en":[{"deceased":false,"name_cn":"刘洪满","name_en":"LIU Hong-man"},{"deceased":false,"name_cn":" 向兵","name_en":" XIANG Bing"},{"deceased":false,"name_cn":" 高兰","name_en":" GAO Lan"},{"deceased":false,"name_cn":" 孟晓武","name_en":" MENG Xiao-wu"},{"deceased":false,"name_cn":" 杜振兰","name_en":" DU Zhen-lan"}]}">

心率变异性及心率减速力对阻塞性睡眠呼吸暂停低通气综合征预测价值

刘洪满, 向兵, 高兰, 孟晓武, 杜振兰

betway必威登陆网址 (betway.com )学报››2021, Vol. 42››Issue (3): 172-175.

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betway必威登陆网址 (betway.com )学报 ›› 2021, Vol. 42 ›› Issue (3) : 172-175. DOI: 10.3969/j.issn.1004-7115.2021.03.003
论著

心率变异性及心率减速力对阻塞性睡眠呼吸暂停低通气综合征预测价值

  • 刘洪满, 向兵, 高兰, 孟晓武, 杜振兰
作者信息 +

The value of heart rate variability and heart rate deceleration in predicting obstructive sleep apnea hypopnea syndrome

  • LIU Hong-man, XIANG Bing, GAO Lan, MENG Xiao-wu, DU Zhen-lan
Author information +
文章历史 +

摘要

目的 探讨心率变异性(HRV)及心率减速力(DC)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断指标的相关性。方法 收集在我院就诊的以白日嗜睡或夜间睡眠打鼾为主诉的101例患者,根据紊乱指数(AHI)分为:对照组(AHI<5)、轻中度组(5≤AHI≤30)、重度组(AHI>30),均进行呼吸睡眠监测(PSG)及24小时动态心电图(HCG)检查,记录PSG参数及HRV指标、DC值,并进行统计学分析。结果 AHI、氧减指数(ODI)、血氧低于90%以下的总时间占睡眠总时间的百分比(T90)、最低氧饱和度(SaO 2min)、全部窦性心搏RR间期的标准差(SDNN)、低频功率(LF)、高频功率(HF)及LF/HF在对照组、轻中度组及重度组间比较差异均具有统计学意义( P<0.05);SDANN、rMSSD、PNN50在重度组与轻中度组、重度组与对照组之间差异具有统计学意义( P<0.05);在OSAHS组中SDNN、LF/HF与AHI、ODI、T90具有相关性( P<0.05),DC值与AHI呈负相关( P<0.05)。结论 HRV指标尤其是LF/HF及DC值对OSAHS的初筛及预后评估有重要意义。

Abstract

Objective: To discuss the correlation between heart rate variability(HRV) and deceleration (DC) in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: The subjects of 101 patients with daytime somnolence or night sleep snoring in our hospital were included and were categorized into three groups according to apnea-hypopnea index (AHI): AHI<5 as control group, 5≤AHI≤30 as mild-to-moderate OSAHS group, AHI>30 as severe OSAHS group.Polysomnography (PSG) test and 24-hour dynamic electrocardiagraphic (DCG) monitoring in all patients were done and PSG parameters, HRV index and DC were recorded and analyzed. Results: Statistically significant differences were found in HRV index, such as SDNN, LF, LF and LF/HF and PSG parameters, such as AHI, ODI, T90 and SaO 2min in between groups. SDANN, rMSSD and PNN50 results revealed significant difference between control group, mild-to-moderate OSAHS group and severe OSAHS group.In the OSAHS group, SDNN and LF/HF were positively linked to AHI, ODI and T90 while DC and AHI were negatively related. Conclusion: HRV index especially LF/HF and DC are important for assessing the prognosis and detecting OSAHS.

关键词

OSAHS/动态心电图/心率变异性

Key words

OSAHS/dynamic electrocardiagraphic (DCG) monitoring/HRV

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导出引用
刘洪满, 向兵, 高兰, 孟晓武, 杜振兰.心率变异性及心率减速力对阻塞性睡眠呼吸暂停低通气综合征预测价值[J]. betway必威登陆网址 (betway.com )学报. 2021, 42(3): 172-175 https://doi.org/10.3969/j.issn.1004-7115.2021.03.003
LIU Hong-man, XIANG Bing, GAO Lan, MENG Xiao-wu, DU Zhen-lan.The value of heart rate variability and heart rate deceleration in predicting obstructive sleep apnea hypopnea syndrome[J]. Journal of ShanDong First Medical University&ShanDong Academy of Medical Sciences. 2021, 42(3): 172-175 https://doi.org/10.3969/j.issn.1004-7115.2021.03.003
中图分类号: R443

参考文献

[1] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[2] Sharma SK, Vasudev C, Sinha S, et al. Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome[J]. Indian J Med Res, 2006,124(3): 281-290.
[3] Zinchuk AV, Gentry MJ, Concato J, et al. Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches[J]. Sleep Med Rev,2017,35: 113-123.
[4] Nagayoshi M, Punjabi NM, Selvin E, et al. Obstructive sleep apnea and incident type 2 diabetes[J]. Sleep Med, 2016,25: 156-161.
[5] Park DH, Shin CJ, Hong SC, et al. Correlation between the severity of obstructive sleep apnea and heart rate variability indices[J]. Journal of Korean Medical Science, 2008, 23 (2):226-231.
[6] Ewing DJ, Campbell IW, Clarke BF, et al.The natural history of diabetic autonomic neuropathy[J]. The Quarterly Journal of Medicine,1980, 49(193):95-108.
[7] Tascilar E, Yokusoglu M, Dundaroz R, et al. Cardiac autonomic imbalance in children with allergic rhinitis[J]. The Tohoku Journal of Experimental Medicine, 2009, 219(3):187-191.
[8] Guilleminault C, Connolly S, Winkle R, et al. Cyclical variation of the heart rate in sleep apnoea syndrome, mechanisms, and usefulness of 24 h electrocardiography as a screening technique[J]. Lancet, 1984, 8369(1):126-131.
[9] Fletcher E, Miller J, Schaaf J, et al.Urinary catecholamines before and after tracheostomy in patients with obstructive sleep apnea and hypertension[J]. Sleep, 1987, 10(1):35-44.
[10] Marrone O, Riccobono L, Salvaggio A, et al.Catecholamines and blood pressure in obstructive sleep apnea syndrome[J]. Chest Journal, 1993, 103(3):722-725.
[11] Grimm W, Koehler U.Cardiac arrhythmias and sleep-disordered breathing in patients with heart failure[J]. Int J Mol Sci, 2014,15(10): 693-705.
[12] Karasulu L, Dalar L, Sökücü S, et al. Heart rate variability analysis of single-channel electrocardiogram can help to differentiate high-risk patients with obstructive sleep apnea syndrome: a study on diagnostic accuracy[J].Anadolu Kardiyol Derg, 2012, 12: 331-338.
[13] Aydin M, Altin R, Ozeren A, et al. Cardiac autonomic activity inobstructive sleepapnea[J].Tex Heart Inst J,2004,31(2):132.
[14] Mehra R, Stone KL, Varosy PD, et al. Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: outcomes of sleep disorders in older men (MrOS sleep) study[J]. Arch Intern Med, 2009,169 (12): 1147-1155.
[15] 温华之.阻塞性睡眠呼吸暂停综合征患者心律失常的发生与心率变异性分析[C]//中国睡眠研究会.中国睡眠研究会第十一届全国学术年会论文汇编.北京:中国睡眠研究会,2019:1.
[16] Gula LJ, Krahn AD, Skanes A, et al. Heart rate variability in obstructive sleep apnea: a prospective study and frequency-domain analysis[J]. Ann Noninvasive Electrocardiol, 2003, 8: 144-149.

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