动态心电图在老年睡眠呼吸暂停综合征中的诊断研究

摘要

目的 探讨动态心电图检查方法在老年睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)患者诊断中的应用价值,为临床疾病诊治提供可循依据.方法 选取2014年10月到2016年5月就诊并治疗的疑似SAS老年患者84例为研究对象.所有患者均经多导睡眠监测仪器检测,依据结果分为SAS组(48例)和非SAS组(36例),分别对两组患者同时进行动态心电图监测及动脉血氧项目检测.对比2组患者动态心电图和动脉血氧项目结果并与多导睡眠监测仪器结果对比,分析动态心电图诊断 SAS的灵敏度和特异性.结果 动态心电图检测 SAS的敏感性为93.75%,特异性为91.67%.SAS组MSaO2和LSaO2值显著低于非SAS组(P<0.05),SAS组患者SIT90和ODI值较非SAS组相比要显著升高(P<0.05).SAS组心电图异常18例,占37.5%,而非SAS组患者中心电图异常为3例,占8.33%,2组比较差异有统计学意义(P<0.01).夜间动态心电图相比,SAS组最高心率高于非SAS组(P<0.05),最低心率低于非SAS组(P<0.05),平均心率高于非SAS组(P<0.05).结论 利用动态心电图进行老年患者SAS诊断是较简便、实用和可靠的方式,可较好地进行SAS的筛查,对预防老年人心脑血管疾病有重大意义.%Objective To investigate the aplication value of dynamic electrocardiogram in diagnosis of sleep apnea syndrome (SAS) in the elderly in order to provide reliable basis for diagnose and treatment of the disease. Methods Eighty-four elderly patients with suspected SAS who were treated in our hospital from October 2014 to May 2016 were enrolled in the study. All the patients were examined by polysomnography,then according to the examination results,these patients were divided into SAS group (n =48) and non-SAS group (n =36). The patients in both groups were examined by dynamic electrocardiogram monitoring and arterial blood oxygen items detection,respectively. The examination results of dynamic electrocardiogram and arterial blood oxygen index detection were anlyzed and compared between the two groups,moreover,the results were compared with those by polysomnography.In addition the sensitivity and specificity of dynamic electrocardiogram in diagnosis of SAS were evaluated.Results The sensitivity and specificity of dynamic electrocardiogram in diagnosis of SAS were 93.75%,91.67%,respectively. The levels of MSaO2and LSaO2in SAS group were significantly lower than those in non SAS group (P<0.05),however,the levels of SIT90 and ODI in SAS group were significantly higher than those in non SAS group (P<0.05). In SAS group,there were 18 cases of abnormal ECG,which accounted for 37.5%,however,in non SAS group,there were 3 cases of abnormal ECG,which accounted for 8.33%,there were significant differences between two groups (P<0.01). In comparison of nighttime dynamic electrocardiogram,the highest heart rate in SAS group was obviously higher than that in non SAS group (P<0.05),however, the lowest heart rate was significantly lower than that in non SAS group (P<0.05),moreover the mean heart rate in SAS group was significantly higher than that in non SAS group (P<0.05). Conclusion The application of dynamic electrocardiogram in diagnosis of SAS in the elderly is a simple, practical and reliable means,which can screen SAS more exactly,thus,which play an important role in prevention of cardiovascular and cerebrovascular diseases in the elderly.