阻塞性睡眠呼吸暂停综合征患者心外膜脂肪组织厚度与左心室几何构型的相关性

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目的:探讨心外膜脂肪组织(EAT)厚度与阻塞性睡眠呼吸暂停综合征(OSAS)患者左室几何构型的相关性。方法:收集2019年1-12月就诊于山西医科大学第一医院呼吸科睡眠室的OSAS患者221例,依据左室质量指数(LVMI)和相对室壁厚度(RWT)分为4组:正常构型(NG)组110例,向心性重构(CR)组56例,向心性肥厚(CH)组32例和离心性肥厚(EH)组23例。采用超声心动图测量左室舒张末期内径、室间隔厚度、左室厚壁厚度、左室射血分数等,计算LVMI、RWT和舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度比值(E/A),比较四组间的年龄、收缩压(SBP)、舒张压(DBP)、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(Lowest-SaOn 2)、夜间平均血氧饱和度(Mean-SaOn 2)、血氧饱和度小于90%的时间占全部睡眠时间的百分比(T90)、氧减指数(ODI)、三酰甘油(TG)、总胆固醇(TC)、EAT厚度及超声心动图参数,通过单因素和多因素线性回归分析EAT厚度与上述参数及左室几何构型的关系。n 结果:①EAT厚度在CH组[(0.50±0.09)cm]和EH组[(0.46±0.07)cm]较NG组[(0.33±0.11)cm]和CR组[(0.36±0.15)cm]明显增厚(均n P<0.05)。各组间年龄、SBP、DBP、AHI、ODI、T90、LVMI、RWT和E/A值差异均有统计学意义(n P<0.05)。②单因素线性回归分析显示EAT厚度与年龄、SBP、DBP、AHI、TG、TC和LVMI、RWT、左室几何构型呈正相关,与Mean-SaOn 2和Lowest-SaOn 2呈负相关。③多因素线性回归分析显示EAT厚度与AHI、TG、TC和左室几何构型独立相关。n 结论:EAT厚度与异常左室几何构型独立相关,提示EAT可能参与了左室的结构重塑过程。“,”Objective:To investigate the relationship between epicardial adipose tissue (EAT) thickness and left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS).Methods:Two hundred and twenty-one OSAS patients were enrolled consecutively from the First Hospital of Shanxi Medical University from January to December 2019. According to left ventricular mass index (LVMI) and relative wall thickness (RWT), OSAS patients were divided into 4 groups based on the left ventricular geometry: 110 with normal geometry (NG group), 56 with concentric remodeling (CR group), 32 with concentric hypertrophy (CH group), and 23 with eccentric hypertrophy (EH group). The patients were examineel by echocardiography, the left ventricular end diastolic diameter, LVMI, interventricular septal thickness, left ventricular posterior wall thickness, left ventricle ejcetion fraction, E/A were collected. Age, systolic blood pressure (SBP), diastolic blood pressure (DBP), apnea hypopnea index (AHI), nocturnal lowest oxygen saturation (Lowest-SaOn 2), nocturnal mean oxygen saturation (Mean-SaOn 2), the percentage of the time that oxygen desaturation below 90%(T90), oxygen desaturation index(ODI), triglyceride (TG), total cholesterol (TC), EAT thickness and the echocardiography parameters were compared among the four groups. The relationships between EAT thickness and the above-mentioned parameters and left ventricular geometry were analyzed by univariate and multivariate linear regressions.n Results:①The higher EAT thickness was found in the CH group [(0.50±0.09)cm] and EH group [(0.46±0.07)cm] compared with the NG group [(0.33±0.11)cm] and CR group [(0.36±0.15)cm] (alln P<0.05). In addition, age, SBP, DBP, AHI, ODI, T90, LVMI, RWT and E/A ratio were all significantly different among the groups (alln P<0.05). ②Univariate linear regression analysis showed that EAT thickness was positively correlated with age, SBP, DBP, AHI, TG, TC and LVMI, RWT, left ventricular geometry, and negatively correlated with Mean-SaOn 2 and Lowest-SaOn 2. ③Multivariate linear regression analysis showed that EAT thickness was independently correlated with AHI, TG, TC and left ventricular geometry.n Conclusions:EAT is independently related to abnormal left ventricular geometry, suggesting that EAT may be involved in the process of left ventricular remodeling.
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