快速眼动睡眠对心血管疾病发病率的影响

doi:10.3969/j.issn.1002-1949.2019.11.002

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摘要目的探讨快速眼动（rapid eye movement, REM）睡眠对心血管疾病发病率的影响。方法利用前瞻性队列研究——美国“睡眠心脏健康研究”数据库（sleep heart health study, SHHS, 注册号：NCT00005275），对纳入多导睡眠图监测记录的受试者基线睡眠时间、睡眠效率及REM睡眠特征进行多元Cox回归模型分析。同时在睡眠呼吸障碍（sleep-disordered breathing, SDB）人群和非SDB人群中进行敏感性分析，来阐明REM睡眠对心血管疾病发病率的影响。结果本研究共纳入4902例受试者，随访11年后，其中有1152例受试者发生心血管疾病。经过多因素分析，发现随着REM睡眠时间延长（HR0.974，95%CI 0.951~0.997，P=0.028）及REM睡眠构成比（percent of sleep time in REM sleep， REMP）增加（HR 0.990, 95%CI 0.980~1.000, P=0.047），心血管疾病发病率减低，差异有统计学意义。敏感性分析结果显示，在SDB人群中，这种相关性更加明显，即REM睡眠时间（HR 0.967，95%CI 0.937~0.997，P=0.034）和REMP（HR0.986，95%CI 0.974~0.999，P=0.039）越高，心血管疾病发生风险越低。结论在社区人群中，REM睡眠与心血管疾病发病率可能存在相关性，其中尤以SDB人群为甚。

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	侯彦丽
	张静静
	李佳媚
	赵玉杰
	张小玲
	高雅
	王小闯
	王岗

关键词 ：快速眼动(REM)睡眠, 心血管疾病, 睡眠呼吸障碍（SDB）

基金资助:国家自然科学基金（81670049, 81770057）；陕西省重点研发计划项目（2017SF-059）

通讯作者: 王岗（1982-），男，博士，教授，博士生导师，重症医学科副主任，E-mail：gang_wang@xjtu.edu.cn。

作者简介: 侯彦丽（1987-），女，硕士，住院医师，E-mail：yanlihou_066@163.com。

引用本文:

侯彦丽，张静静，李佳媚，赵玉杰，张小玲，高雅，王小闯，王岗. 快速眼动睡眠对心血管疾病发病率的影响[J]. 中国急救医学, 2019, 39(11): 1021-1025.
Hou Yan-li, Zhang Jing-jing, Li Jia-mei, Zhao Yu-jie, Zhang Xiao-ling, Gao Ya, Wang Xiao-chang, Wang Gang. Effect of rapid eye movement sleep on the incidence of cardiovascular diseases. Chinese Journal of Critical Care Medicine, 2019, 39(11): 1021-1025.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.11.002 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I11/1021

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