夜间低氧血症参数与冠状动脉微血管功能障碍之间的关系：一项横断面研究。

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2024-12-28 eCollection Date: 2024-01-01 DOI:10.2147/NSS.S494018

Lanxin Feng, Xin Zhao, Jianqiao Song, Shuwen Yang, Jianping Xiang, Min Zhang, Chenchen Tu, Xiantao Song

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引用次数: 0

摘要

目的：阻塞性睡眠呼吸暂停（OSA）与冠状动脉微血管功能障碍（CMD）之间存在联系，但其机制尚不清楚。本研究旨在探讨osa相关夜间低氧血症参数与CMD的相关性。方法：这是一项观察性的单中心研究，纳入住院期间接受多导睡眠图和冠状动脉造影的患者。采用血管微循环阻力指数（AccuIMR）检测CMD的存在。分类变量比较采用卡方检验或Fisher精确检验。正态分布和非正态分布连续变量的比较分别采用t检验和Mann-Whitney u检验。采用单因素和多因素logistic回归分析评估夜间低氧血症参数与CMD之间的关系。结果：本研究共纳入133例患者，其中72例（54.14%）有CMD证据。CMD患者表现出更高的OSA患病率和更严重的夜间缺氧。调整潜在混杂因素后，最小氧饱和度(minSpO2)≤90% (OR 5.89；95% ci 1.73-19.99；P=0.004)，血氧饱和度低于90%的时间百分比(T90)≥5% (OR 3.13；95% ci 1.05-9.38；P=0.041)与CMD独立相关。然而，呼吸暂停低通气指数（AHI）与CMD之间无显著相关性。结论：夜间低氧血症参数与CMD相关。低氧血症参数可能比AHI更敏感地反映OSA与CMD的相关性。

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Association Between Nocturnal Hypoxemia Parameters and Coronary Microvascular Dysfunction: A Cross-Sectional Study.

Objective: There is a connection between obstructive sleep apnea (OSA) and coronary microvascular dysfunction (CMD), but the underlying mechanisms remain unclear. This study aims to evaluate the correlation between OSA-related nocturnal hypoxemia parameters and CMD.

Methods: This is an observational, single-center study that included patients who underwent polysomnography and coronary angiography during hospitalization. The presence of CMD was determined by angio-based index of microcirculatory resistance (AccuIMR). Categorical variables were compared using chi-square test or Fisher exact test. The t-test and Mann-Whitney U-test were used to compare normally and non-normally distributed continuous variables, respectively. Univariate and multivariable logistic regression analyses were performed to evaluate the relationship between nocturnal hypoxemia parameters and CMD.

Results: A total of 133 patients were included in this study, of whom 72 (54.14%) had evidence of CMD. Patients with CMD exhibited a higher prevalence of OSA and experienced more severe nocturnal hypoxia. After adjusting for potential confounding factors, minimum oxygen saturation (minSpO₂) ≤90% (OR 5.89; 95% CI 1.73-19.99; P=0.004) and the percentage of time spent with oxygen saturation below 90% (T90) ≥5% (OR 3.13; 95% CI 1.05-9.38; P=0.041) were independently associated with CMD. However, no significant association was observed between apnea-hypopnea index (AHI) and CMD.

Conclusion: Parameters of nocturnal hypoxemia are associated with CMD. Hypoxemia parameters may more sensitively reflect the correlation between OSA and CMD than AHI.

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.