The Relationship Of Obstructive Sleep Apnea Hypopnea Syndrome And Coronary Heart Disease And Its Risk Factors

Objective:Obstructive Sleep Apnea Hypopnea Syndromes(OSAHS) is a kind of sleeping disorder disease caused by repeated occurrence of partial or total upper airway obstruction, leading to repeated acute hypoxia, sleep fragments, and excessive sleepiness in daytime. Epidemiological evidence indicates OSAHS as a new independent risk factor of coronary heart disease(CHD) is closely associated with the incidence rate of CHD, severity and complexity of the coronary artery lesions, significantly increasing mortality of patients. At present, the clinical treatment means include control of risk factors of CHD, drug therapy, and instrumentation therapy consisting of coronary artery bypass grafting(CABG) and percutaneous coronary intervention(PCI). For a long time, the choice of operation methods, CABG or PCI, for partial coronary artery lesions has been debatable. It needs a feasible method to guide to how to choose the operation method. To guide therapy, SYNTAX Score(SXscore) proposed in2008ESC annual meeting is a new integral system for risk stratification according to anatomical features of coronary artery lesions. It bases on lesion region, severity, bifurcation, calcification and so on to evaluate complexity of coronary artery lesions. Aim of the study is following:make sure the relationship between OSAHS and SXscore, risk factors of CHD.Methods:We selected103examples in Tianjin Chest Hospital from May2006to October2012. Apply Philips Respironics Alice5polysomnography to lead to diagnosis OSAHS and its severity. According to diagnostic criteria eatablished by respiratory disease branch of sleep-disordered breathing study group of the Chinese Medical Association, all examples were divided into three groups:mild group(n=29), moderate group(n=32), severe group(n=42). Collect data about risk factors of CHD from the examples undergoing coronary angiography(CAG), and then calculate SXscore.All patients with ultrasonic cardiogram testing were drawn fasting blood to obtain data of blood routine, coagulation, liver function, renal function and blood lipid. Using IBM SPSS19.0software to analysis data. Results:(1) There were no differences in age, height, ratio of sex, hypertension, diabetes, smoke among three groups(P>0.05), weight and BMI in severe group was significantly higher than mild and moderate groups (P<0.05).(2) There were no differences in erythrocyte, hemoglobin, platelet and D-dimer of three groups(P>0.05), fibrinogen in severe group was higher than mild group (P<0.01).(3) Three groups levels of LDL-c, HDL-c, TG, AST and ALT had no differences(P>0.05), severe group level of TC (P<0.05), UA (P<0.05), Cr (P<0.01) was higher than mild and moderate groups.(4)Echocardiography indicated there were no differences in LVD and LVEF among three groups(P>0.05), severe group had larger LAD and higher PAP than other two groups (P<0.01), and severe (P<0.01) and moderate (P<0.05) groups RVD was larger than mild.(5) SXscore of severe group was higher than mild and moderate groups (P<0.01), and which increased with the elevated apnea hypopnea index (r=0.307,P<0.01).(6) Binary logistic analysis displayed AHI and SXscore can not be used as a prognostic indicator.Conclusions:In OSAHS patients with CHD, there is a positive correlation between AHI and SXscore. With the increasing of OSAHS severity, SXscore is significanty increased, and the severity and complexity of coronary artery lesions are also increased. Moreover, OSAHS has negative effect on Lipid metabolism, renal function and structure of heart. It can offer a reference for treatment of OSAHS patients with CHD.