Effects Of Different Types Of Obstructive Sleep Apnea Hypopnea Syndrome On Cardiovascular Complications

Objective:To investigate the characteristics of apnea type and hypopnea type in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）and the effects of different types on cardiovascular complications.Methods:A total of 262 patients with OSAHS in the second Hospital of Lanzhou University from November 2017 to August 2020 were retrospectively enrolled.According to the results of sleep monitoring,according to the proportion of hypopnea to total respiratory events,the patients were divided into two groups:hypopnea predominant（HP）and apnea predominant（AP）.Independent sample t-test,Mann-Whitney U test and chi-square test were used to compare the differences between the two groups,Analysis of the characteristics of each type.Patients were divided into four groups according to the proportion of hypopnea:group 1<25%,group 2 25%-50%,group 3 50%-75%,and group 4≥75%,Logistic regression analysis was used to predict the relationship between the proportion of hypopnea and cardiovascular disease,and to explore the effect of hypopnea ratio on cardiovascular complications.Results:（1）A total of 262 patients with OSAHS were enrolled,with an average age of 51.72±12.08.among them,there were 73 patients in AP group and189 patients in HP group.HP was mainly concentrated in mild OSAHS patients（42.9%）,AP was more common in severe OSAHS patients（56.2%）.There was no difference in gender between the two groups,compared with HP group,AP group was younger,minSpO₂ was lower,ODI and AHI were higher,and the prevalence rate of coronary artery disease was higher.Multivariate logistic regression analysis showed that smoking,minSpO₂ and TG were risk factors for hypopnea.（2）The proportion of hypopnea in patients with OSAHS is a risk factor for pulmonary hypertension,hypertension and coronary artery disease,and is an independent risk factor for pulmonary hypertension and coronary artery disease.The proportion of hypopnea in patients with OSAHS was divided into two groups as independent variables and cardiovascular complications as dependent variables,the results of logistic regression analysis showed that:the risk of pulmonary hypertension in group 2 and group 3 was lower than that in group 4,the risk of hypertension in group 2 was higher than that in group 4,and the risk of coronary artery disease in group 3 was higher than that in group 4.Adjustment of age,BMI,smoking and other factors,the risk of pulmonary hypertension in group 2 and group3 was still lower than that in group 4（43.9%and 33.9%）,and the risk of coronary artery disease was higher than that in group 4（3.359 times and 3.469 times）.Conclusion:（1）56.2% of AP patients have severe OSAHS,most of HP suffer from mild OSAHS,AP nocturnal hypoxia and the severity of OSAHS is more serious than HP.Smoking and minSpO₂ are risk factors for hypopnea.（2）The proportion of hypopnea is an independent risk factor for pulmonary hypertension and coronary artery disease.The lower the proportion of hypopnea,the lower the risk of pulmonary hypertension and the higher the risk of coronary artery disease.Clinically,the risk of cardiovascular disease in patients with OSAHS can be predicted according to the ratio of hypopnea to total respiratory events, which provides a basis for individualized treatment.