| ObjectiveTo investigate the number and type of arrhythmia occurring in patients with obstructive sleep apnea syndrome at different times of the night and to study the relationship between nocturnal arrhythmia and chronomedicine of TCM in patients with obstructive sleep apnea syndrome.MethodsRandomly selected from February 2016 to February 2018 in our hospital outpatient or inpatient diagnosis of OS AS patients and in the short term dynamic ECG(one week)60 patients were selected as the experimental group,randomized to meet the inclusion criteria And exclude the standard PSG(polysomnography)check exclude 60 patients with OSAS as the control group.Retrospective analysis of the two groups of patients in the corresponding time of PSG examination of electrocardiogram arrhythmia,according to the time of arrhythmia corresponds to the TCM hour,compare different time of the arrhythmia;according to OSAS severity level,the degree of hypoxia and the lowest blood oxygen level,the results of the corresponding hour of Holter at night,compare the different degrees of OSAS and different degrees of hypoxia and arrhythmia occurrence at different times of the distribution.ResultsThe results of the comparison between the experimental group and the control group showed that 58 cases of arrhythmias occurred in the experimental group(OSAS group),including 29 cases of sinus bradycardia,3 cases of sinus tachycardia,and 48 cases of atrial premature contraction.50 cases of premature beats,14 cases of short upper chamber velocity,and 9 cases(1 degree atrioventricular block in one degree,1 case of complete right bundle branch block,3 cases of short ventricular tachycardia,4 cases of atrial fibrillation/atrial flutter);And 53 cases of arrhythmias occurred in the control group(non-OSAS group),including 9 cases of sinus bradycardia,2 cases of sinus tachycardia,29 cases of atrial premature contraction,25 cases of ventricular contraction,and short bursts.5 cases of supraventricular tachycardia,other 6(I degree atrioventricular block in 1 case,3 cases of complete right bundle branch block,2 cases of atrial fibrillation/atrial flutter).After statistical analysis,there was no statistically significant difference between the two groups in the incidence of sinus tachycardia and other types of arrhythmia(P>0.05);in the occurrence of sinus bradycardia,atrial premature beat,supraventricular The number of tachycardia and ventricular premature beats were all different(P<0.05).OSAS patients were more likely to have atrial premature beats,ventricular premature beats,supraventricular tachycardia and other arrhythmias than the control group.Patients with OSAS were more likely to have sinus bradycardia(P<0.05).In the comparison of the number of arrhythmias at different times during the night between the experimental group and the control group,the average total cardiac arrhythmia constant in the experimental group was 84.50+68.42,and the average arrhythmia at each hour was 17.93+17*57 in haishi,16.91±16.94 in zishi,and l5.55±16.65 in zishi.29.77±21.16 in yinshi,16.66±14.62 in maoshi;and 19.47±21.04 of the average total cardiac arrhythmia in the control group.The average arrhythmia at each time point was 4,90±5.55 in haishi,6.20±7.34 in zishi,3.67±4.31 in choushi,and 3.57±5.06 in yinshi.3.05+3.87 in maoshi.After statistical analysis,there was a statistically significant difference in the number of arrhythmia events between the two groups at the time of haishi,zishi,choushi,yinshi,and maoshi(P<0.01).The number of arrhythmia in the experimental group was more distribution in yinshi(P<0.05),and there was more distribution in zishi in the control group(P<0.05).There were 60 cases of OSAS in the experimental group and 12 cases of mild OSAS,including 2 during daytime sleepiness.The average AHI value was 9.43±2.75,the average minimum oxygen saturation was 80.50±6.40,and the average total occurrence of arrhythmia was 23.11±25.64;Degree of OSAS accounted for 14 people,including 2 during daytime sleepiness,the average AHI value was 23.89±3.45,the average minimum oxygen saturation was 74.36±13.18,and the average total arrhythmia frequency was 63.17±28.30;34 patients with severe OSAS accounted for 34 cases,including daytime sleepiness.The average AHI was 36.38+19.63.The mean minimum oxygen saturation was 67.41±8.35.The average total arrhythmia was 132.08+69.85.After statistical analysis,there were differences in the total number of arrhythmia between different degrees of OSAS(P<0.05),and the performance of severe OSAS was that the total occurrence of arrhythmias was more frequent,followed by moderate,slightly lower;and different The level of OSAS also showed differences in the minimum blood oxygen level(P<0.05).The worse the OSAS was,the lower the LSa02 level was.In terms of drowsiness,the patients with severe OSAS had statistically significant differences with mild to moderate OSAS,and the severity was more likely to occur.Drowsiness(P<0.05).Among patients with OSAS of varying degrees,12 patients with mild OSAS had an average arrhythmia of 2.58±2.81 in haishi,2.67±1.97 in zishi,1.42±2.11 in choushi,5.17±3.66 in maoshi,and 2.25±2.73 in maoshi;the average arrhythmia times in 14 cases of moderate OSAS were 7.21±10.37,7.19±7.78,7.14±7.80,20.57±11.59,and 7.14±8.83,respectively;and in the 34 cases of severe OSAS,the average number of arrhythmia at each time was 22.53±11.52,23.76±15.65,23.15±14.93,35.15±19.10,and 20.24±14.00 respectively.After statistical analysis,the distribution of arrhythmia in mild OSAS group was not statistically significant at different time points(P>0.05),and the difference in the number of night-time arrhythmia caused.by moderate and severe OSAS was statistically significant(P<0.05),and OSAS had the most arrhythnia at all times.It was found that there was no significant difference in sleepiness between mild and moderate OSAS(P>0.05),but there was a statistically significant difference between mild and severe OSAS patients with sleepiness and between moderate and severe OSAS patients with sleepiness.P<0.05)·OSAS caused different types of arrhythmias in the distribution of time,there were 13 cases of sinus bradycardia in haishi,20 cases in zishi,24 cases in choushi,25 cases in yinshi,20 cases in maoshi;supraventricular tachycardia was 0.12±0.42 in haishi,0.50 ± 1.97 in zishi,0.08 ± 0.42 in choushi,0,30 ± 0.93 in yinshi,0.08 ± 0.33 in maoshi.atrial premature beats were 11.68±18.77 in haishi,11.05±16.26 in zishi,6.84±12.31 in choushi,14.94±22.65 in yinshi,9.46±16.57 in maoshi.And the ventricular premature beats were 20.83±22.95,19.50±19.73,21.79±22.92,25.45 ± 22.40,and 15.84±13.51 respectively.After statistical analysis,sinus bradycardia and supraventricular tachycardia were not statistically significant at five time points(P>0.05),but statistical distributions of ventricular premature beats and atrial premature beats were statistically significant(P<0.05),and it is distributed more frequently at the time of yinshi and zishi.Among 60 OSAS patients,mild hypoxia occurred in 5 cases.The average arrhythmia frequency was 3.40±5.46 in haishi;the average number of arrhythmia was 7.00±11.79 in zishi,7.00±11.79 in choushi,yinshi was 14.40±13.50,and maoshi was 6.40±5.55.There were 13 cases of moderate hypoxia.The number of arrhythmia occurred in each time was 11.58d=13.98,18.58±9.51,and 11.08±10.83 respectively.At the time of 19.58±16.69 in sputum and 7.08±8.52 in sputum;in 42 cases of severe hypoxia,the frequency of arrhythmia at eachhourwas 17.26±16.00,18.70±16.35,16.44±15.32,28-79±20.24,and 16.23±14.80 respectively.Statistical analysis showed that there was no statistically significant difference in the distribution of arrhythmias in patients with mild or moderate hypoxic OSAS at different times(P>0.05);the number of nighttime arrhythmias in patients with severe hypoxic OSAS was different.The distribution in the hour was statistically significant(P<0.05),among which there were more frequent arrhythmias at the time of sputum(P<0.05).ConclusionIn the type of arrhythmia,OSAS patients are more prone to atrial premature beats,ventricular premature beats,sinus bradycardia;OSAS caused by different types of arrhythmia in the distribution of time,sinus bradycardia in the distribution of each hour No obvious biased,but in premature ventricular contractions,atrial premature beats in Yin time distribution of more;OSAS more serious,the lower the lowest blood oxygen level.The frequency of arrhythmia,OSAS patients with atrial premature beats,ventricular premature beats and other arrhythmia more often,and the performance of OSAS severity is higher,the more the number of arrhythmia;in varying degrees of OSAS in different The number of arrhythmia occurred at the time,the three were the highest incidence of arrhythmia when Yin,and with the OSAS increased,the incidence of arrhythmia increased.And the more the degree of hypoxia,the incidence of arrhythmia in different times will increase,and the time of 03:00am-05:00am is more. |
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