OSAHS严重程度与CABG后新发心房颤动关联研究

摘要

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与冠状动脉旁路移植术(CABG)后新发心房颤动(AF)的关系.方法 选取2016年1月~12月于济宁医学院附属医院接受CABG治疗且伴有OSAHS患者90例(观察组),同时采用1:3配对选取行CABG不伴有OSAHS患者270例(对照组),比较两组术后新发AF比例.结果 与对照组相比,观察组术后新发AF比例为38.89%,明显升高,差异比较有统计学意义(P<0.05);和对照组相比,观察组术后生化指标及心脏超声指标比较差异无统计学意义(P>0.05);与对照组相比,观察组术后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、全血高切粘度、全血低切粘度和血浆粘度分别为(110.54±21.40)U/L、(12.41±4.50)U/L、(10.82±1.63)mPa·s、(18.91±3.06)mPa·s和(2.41±0.32)mPa·s,均较高(P均<0.05).重度OSAHS患者术后新发AF的比例为76.19%,明显高于轻度和中度OSAHS患者(P<0.05).Logistic回归分析结果显示:年龄(≥50岁)、OSAHS是CABG术后新发AF的危险因素(OR=1.085和3.071,P均<0.05).结论 OSAHS是CABG术后新发AF的危险因素;且OSAHS严重程度越高,其发生AF的比例越高.%Objective To investigate the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and new onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods A total of 90 OSAHS patients with CABG from January 2016 to December 2016 were selected (observation group), and 270 patients with CABG without OSAHS were selected by 1:3 pairing (control group). We compared the proportion of new AF in two groups.Results The proportion of new onset AF in observation group was 38.89%, which was significantly higher than that in control group, the difference was statistically significant (P<0.05). There was no significant difference between observation group and control group in the biochemical indexes and the cardiac ultrasound indexes (P>0.05). Creatine kinase (CK), creatine kinase isoenzyme (CK-MB), whole blood high shear viscosity, whole blood low shearviscosity and plasma viscosity in observation group were (110.54±21.40)U/L, (12.41 ±4.50)U/L, (10.82±1.63) mPa·s, (18.91±3.06) mPa·s and (2.41±0.32)mPa·s, which were significantly higher than those in control group (P<0.05). The proportion of new onset AF in patients with severe OSAHS was 76.19%, which was significantly higher than that in mild and moderate OSAHS patients (P<0.05). Result of logistic regression analysis showed that age (≥50 years) and OSAHS were risk factors of new onset AF after CABG (OR=1.085 and 3.071,P<0.05).Conclusion OSAHS is a risk factor for AF after CABG. The higher the severity of OSAHS, the higher the proportion of AF.