待機的冠動脈造影を受けた患者における睡眠呼吸障害のスクリーニング

Screening of Sleep Disordered Breathing in the Patients Undergoing Coronary Angiography

要旨　背景：睡眠呼吸障害(sleep disordered breathing;SDB)は各種循環器疾患の促進因子である．診断治療の介入が推奨されているが，自覚症状に乏しく発見されていない患者が多い．待機的冠動脈造影検査(coronary angiography;CAG)は一般的に入院にて行われることが多い．

　目的：CAGを受ける患者におけるSDBスクリーニングの施行有用性とSDB罹患率の検討．

　対象：CAGを受ける43名．

　方法：入院中，簡易型睡眠ポリグラフで無呼吸低呼吸指数(apnea hypopnea index;AHI)を測定．

　結果：全例で問題なくAHI測定が可能であった．中等症以上のSDB(15≦AHI)を18例(42%)に認め，経皮的冠動脈形成術の既往，body mass index≧25以上の症例で有意にその頻度が高かった．

　結語：CAG施行患者にSDBのスクリーニングを行うことでSDB合併例を効率良く発見できる可能性が示唆された．

　Background:Because sleep disordered breathing(SDB)is an promoting factor for many cardiovascular diseases, diagnostic and therapeutic intervention are recommended. However, it is difficult to diagnose SDB in asymptomatic patients. Expectant coronary angiography(CAG)is often performed with hospitalization.

　Purpose:An assessment of the feasibility of SDB screening and its prevalence in hospitalized patients undergoing CAG.

　Patients:Forty-three patients who underwent CAG.

　Methods:Within the hospitalization period, the apnea hypopnea index(AHI)was monitored by portable polysomnography.

　Results:In all patients, the AHI could be monitored without any event. In 18 patients(43%), moderate or severe SDB(AHI＞15)was detected. Such patients were identified significantly more often in the group with a history of percutaneous catheter intervention or with a body mass index≧25.

　Conclusion:Screening in the patients who undergo CAG may be able to diagnose the patients with SDB effectively.