Correlation analysis of heart rate, blood pressure and autonomic nerve function recovery in obstructive sleep apnea hypopnea syndrome patients after uvulopalatopharyngoplasty / 中国医师进修杂志

ABSTRACT

Objective:To investigate the relationship between heart rate, blood pressure and autonomic nerve function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) after uvulopalatopharyngoplasty (UPPP).Methods:One hundred patients with OSAHS who underwent UPPP in Wuhan Central Hospital Tongji Medical College, Huazhong University of Science and Technology from July 2018 to July 2019 were selected. According to the disease grade of apnea hypopnea index (AHI), 38 cases were divided into mild group (AHI 5 to 15 times/h) and 62 cases were divided into severe group (AHI>16 times/h). The preoperative and postoperative polysomnography and 24 h dynamic electrocardiogram records was used to monitor the patient′s data, and the quality of sleep was compared before and after treatment in patients with sleep apnea, including apnea and AHI, the longest apnea time (LAT), the lowest oxygen saturation (L SaO 2) and ratio of time with blood oxygen saturation lower than 90% to total sleep time (TSPO 2 90%); patient′s heart rate, including maximum heart rate, minimum heart rate and average heart rate; heart rate variability (HRV) and related indexes of patients, including all sinus RR interval (SDNN), RR interval mean standard deviation (SDANN), root mean square (RMSSD) of adjacent RR interval difference, the percentage of adjacent NN>50 ms in total sinus interval difference (PNN50%) and HRV triangle index; autonomic nerve function of patients, including high frequency band (HF, 0.05 to 0.15 Hz), low frequency band (LF, 0.01 to 0.05 Hz) and LF/HF; patients′blood pressure, including systolic and diastolic blood pressure. Results:Compared with those before treatment, AHI, LAT, TSPO 2 90%, SDNN, SDANN, RMSSD, PNN50% and HRV trigonometric index were decreased in mild group and severe group after treatment, L SaO 2 was increased, and there were statistical differences ( P<0.05). Compared with those of mild group, AHI, LAT, TSPO 2 90%, SDNN, SDANN, RMSSD, PNN50% and HRV trigonometric index were increased in severe group before treatment, LSaO 2 was decreased, and there were statistical differences ( P<0.05). In the mild group before treatment, mild group after treatment, severe group before treatment and severe group after treatment, the highest heart rates were (127.22 ± 21.87), (72.26 ± 6.15), (143.71 ± 22.09) and (75.03 ± 8.21) beats/min, the lowest heart rates were (50.18 ± 5.21), (61.27 ± 7.10), (42.18 ± 5.13) and (59.67 ± 6.77) beats/min, and the average heart rates were (71.95 ± 8.36), (62.37 ± 6.28), (85.72 ± 11.04) and (64.30 ± 5.89) times/min. After treatment, the maximum heart rate and average heart rate of mild group and severe group were lower than those before treatment, the lowest heart rate was higher than that before treatment, and there were statistical differences ( P<0.05). In the mild group before treatment, mild group after treatment, severe group before treatment and severe group after treatment, the LF were (1107.61 ± 151.69), (768.42 ± 135.18), (1 307.57 ± 182.30), (770.41 ± 160.25) ms 2, HF were (781.81 ± 91.46), (457.24 ± 72.13), (835.03 ± 152.75), (450.44 ± 94.10) ms 2, LF/HF were 1.76 ± 0.25, 1.35 ± 0.14, 1.98 ± 0.32, 1.38 ± 0.11. After treatment, LF, HF and LF/HF in mild group and severe group were lower than those before treatment ( P<0.05); before treatment, LF, HF and LF/HF rate in severe group were higher than those in mild group ( P<0.05). In the mild group before and after treatment, mild group before and after treatment, the systolic blood pressure were (125.01 ± 15.23), (103.22 ± 17.93), (146.13 ± 21.60), (111.25 ± 23.63) mmHg (1 mmHg = 0.133 kPa), and the diastolic blood pressure were (82.27 ± 11.49), (66.13 ± 10.27), (93.52 ± 16.06), (69.10 ± 14.39) mmHg. After treatment, systolic and diastolic blood pressure in mild group and severe group were lower than those before treatment, and there were statistical differences ( P<0.05); systolic and diastolic blood pressure in severe group were higher than that in mild group before treatment, and there were statistical differences ( P<0.05). LF/HF was positively correlated with AHI, mean heart rate, systolic and diastolic blood pressure ( P<0.05), and negatively with HRV triangle index ( P<0.05). Conclusions:Symptoms of OSAHS patients recover gradually after UPPP, and the recovery of autonomic nerve function is correlated with AHI, heart rate and blood pressure.