目的:了解阻塞性睡眠呼吸暫停綜合征患者的心率變異改變。方法:對67例睡眠打鼾患者同步進行24小時動態心電圖及多導睡眠圖監測。根據PSG檢測結果分為OSAS組和單純鼾癥組,比較組間低頻峰(LF),高頻峰(HF),低頻峰與高頻峰的比值(LF/HF),正常RR間期平均值及其標準差值(SDNN),正常RR間期差值均方根(rMSSD)。結果:OSAS組中,頻域分析指標:LF,HF,均低于單純鼾癥組,LF/HF高于對照組,時域分析指標:SDNN,rMSSD均低于對照組。結論:OSAHS患者心率變異性降低。
目的:了解阻塞性睡眠呼吸暫停綜合癥(OSAHS)患者夜間心律失常的發生情況、常見類型及相關因素。方法:對67例睡眠打鼾患者同步進行動態心電圖及多導睡眠圖監測。以呼吸暫停指數及夜間最低氧飽和度將研究對象進行分組,比較分析夜間心律失常發生率及發生類型并進一步分析夜間心律失常的相關因素。結果:OSAS組的夜間心律失常發生率顯著高于單純鼾癥患者。隨著OSAS加重,呼吸暫停低通氣指數逐漸增大,夜間氧飽和度下降越明顯,心律失常發生率升高,發生時間延長、惡性程度增加,尤其以緩慢型心律失常的發生率增多。結論:OSAHS患者夜間心律失常的發生率及嚴重程度與OSAHS嚴重程度呈正相關,夜間心律失常的誘發與呼吸暫停低通氣指數及低氧血癥密切相關。應重視夜間心律失常患者合并存在的OSAHS的診治。
Objective To explore the clinical characteristics of patients with severe pandemic H1N1 Influenza in Sichuan and risk factors related to patients’ prognosis. Methods We observed 135 severe patients who came to hospitals for pandemic H1N1 Influenza from 12 cities in Sichuan, China,between September 12, 2009 to December 14, 2009, and described their baseline characteristics, treatment,and outcomes. A stepwise multiple Logistic-regression analysis was used to evaluate the independentpredictors of death. Results Of the 135 patients we studied, 86 patients were male. The average age was ( 28. 2 ±19. 3) years old, while patients between 19 to 45 years of age accounted for 47. 4% . 96 patients ( 71. 1% ) presented with fever. 51 patients( 37. 8% ) had comorbid conditions. The most frequent organdysfunction was seen in lung ( 71. 1% ) , liver( 27. 4% ) and cardia( 24. 4%) ; 130 patients( 96. 3% ) had received oseltamivir, 26 patients ( 19. 3% ) required mechanical ventilation. 12 of the 135 patients died.Compared with the survivors, patients who died were more likely to have a higher age, lower average bloodpressure when admitted, more organ dysfunction, and more likely to have cardia or nervous system dysfunction. The nonsurvivors also seemed to have less opportunity to be exposed to neuraminidase inhibitors, and have more demand for mechanical ventilation. The P value were all under 0. 05. The multipleLogistic-regression analysis showed the independent predictors of death were the average blood pressure when admitted and the demand for mechanical ventilation . The P value were both under 0. 05. The OR value was 0. 86(95% CI 0. 002-0. 936) and 13. 86( 95% CI 1. 146-16. 583) , respectively. Conclusions For these severe patients with pandemic H1N1 Influenza we study, the male patients are more than female. Most patients are between 19 to 45 years of age. The most frequent organ dysfunction is seen in lung, liver and cardia. The mortality of these patients is 8. 9% . Compared with the survivors, patients who died were morelikely to have a higher age, lower average blood pressure when admitted, more organ dysfunction, and more likely to have cardia ornervous systemdysfunction. The nonsurvivors also seemed to have less opportunity to be exposed to neuraminidase inhibitors, and more demand for mechanical ventilation. The multiple Logisticregression analysis showed the independent predictors of death are the average blood pressure and the demand for mechanical ventilation. The OR value is 0. 86 ( 95% CI 0. 002-0. 936) and 13. 86 ( 95% CI1. 146-16. 583) respectively.