Hội chứng ngưng thở khi ngủ dạng tắc nghẽn ở người có bệnh tim thiếu máu cục bộ

Reporter: Dr Nguyen Nhat Quang BACKGROUND OSAS (Obstructive Sleep Apnea Syndrome) Repetitive complete and/or partial collapses of the upper airways Epidemiology 4% male–2% female – 10% Male: 4,1% - 7,5% Female : 2,1% - 3,2% BACKGROUND • Negative impact on the health and quality of life – Drowsiness and fatigue during the day – Neurophysiological changes • Relating to many metabolic and cardiovascular diseases BACKGROUND hyperactivity of the sympathetic endothelial dysfunction atherosclerosis systemic hypertension Company Logo BACKGROUND Evaluate the frequency, clinical and preclinical characterization of obstructive sleep apnea syndrome in patients with ischemic heart disease Survey the relationship between the apnea hyponea index and neck circumference, waist circumference, BMI, blood pressure, blood lipid parameters, SpO2 and Gensini score Diagnostic criteria OSA = Cr A and/or Cr B + Cr C Criteria A: excessive daytime sleepiness Criteria B: ≥ following criteria Gasping and choking sensations More frequent arousals Insomnia Daytime fatigue Memory and intellectual impairment Criteria C: AHI ≥ events/h The severity of OSAS AHI (Apnea-Hyponea Index)  Mild: AHI = – 15 events/h  Moderate: AHI =16 – 30 events/h  Heavy: AHI > 30 events/h METHODS AND SUBJECTS 2.1 SUBJECTS Criteria for patient selection:  ≥ 50% stenosis of coronary arteries and suspected evidence of obstructive sleep apnea syndrome  Cỡ mẫu thuận lợi OSAS (+) Polysomnography OSAS (-) METHODS AND SUBJECTS Exclusive criteria: • Non-stenosis or stenosis [...]...2 METHODS AND SUBJECTS 2.2 Time of research 02/2012 – 07/2014 2.3 Methods Cross-sectional descriptive study 11 The study progress Age Gender Smoking Diabetes mellitus 1.General characteristic Hypertension BMI Neck circumference Waist circumference The study progress 2 Survey on clinical characteristic  Symptoms of OSAS: Apnea (có người chứng kiến) Loud snore (có người chứng kiến) Gasping and/or... than 3,7 times compared with the normal people 33 Functional symptoms of OSAS Loud snore OSAS (+) (n = 80) n % 52 81,3 OSAS (-) (n = 39) n % 12 18,7 Excessive daytime sleepiness 44 95,7 2 Morning headache 51 85,0 Memory/intellectual impairment 43 87,8 Functional symptom Total p 64 < 0,05 4,3 46 < 0,05 9 15,0 60 < 0,05 6 12,2 49 < 0,05 •Nguyen Xuan Bich Huyen: snore (97,95%/male,100%/female, daytime sleepiness(31,3%/male,16,7%/female)... Other branches: x 0.5 Gensini score = Total score of the number of lesions multiplicated with the factor 16 The position of coronary lesions and factor of lesions in accordance with Gensini score 17 TIMI SCALE TIMI 3 2 1 0 Characteristic The contrast flows freely and absorbed rapidly in front of and behind the lesion of the coronary artery The contrast is over the lesion to distal more slowly and be ale... người chứng kiến) Loud snore (có người chứng kiến) Gasping and/or choking sensations Excessive daytime sleep More frequent arousals Insomnia Morning headache Memory and intellectual impairment  Blood pressure 13 The study progress 3 Survey on subclinical characteristic 3.1 Glucose, bilan lipid máu 3.2 Coronary angiography 14 Evaluate the abnormality of coronary artery • Determine the number of... contrast is through the lesion to the distal of coronary artery (occlusion or non-recovery) 18 The study progress 3.3 Polysomnography  Patients were included in the explorative room on the appropriate time according to each patient's habits, then they were fixed in Respironics Stardust II of the Respironics company (Germany), including the measuring device of SpO2, nasal airflow, respiratory muscle... symptom Total p 64 < 0,05 4,3 46 < 0,05 9 15,0 60 < 0,05 6 12,2 49 < 0,05 •Nguyen Xuan Bich Huyen: snore (97,95%/male,100%/female, daytime sleepiness(31,3%/male,16,7%/female) • Le Thuong Vu: snore (92%), daytime sleepiness (65,8%) • Goksan B: the prevalence of pts with morning headache in OSAS group > non-OSAS group (33,6% > 8,9%, p