曹得清,汪晓洲

随着生活水平的提升，阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的发病率亦呈上升趋势。该病与心律失常之间的关联已被广泛研究证实，研究范围从流行病学调查扩展到临床观察，再到探究二者的病理生理基础，相关实验研究正逐步深化。尽管多数现有研究侧重于OSAHS与心房颤动（AF）的相关性探讨，但OSAHS与室性心律失常的关系亦逐渐受到学界关注。其中，核心机制涉及OSAHS引起的自主神经系统功能失调，具体表现在呼吸暂停期间副交感神经活动过度增强及后续交感神经过度激活，为心律失常的诱发提供了条件。此外，OSAHS促成心律失常的其他生理病理机制涵盖间歇性低氧所导致的胸腔内压力变化及高碳酸血水平。OSAHS介导心律失常的间接路径则包含了全身性炎症加剧、氧化应激增加、血栓形成倾向加强及血管功能异常。随着OSAHS病情的进展，随之出现的并发症，诸如高血压、心房扩张及纤维化、心室肥大、冠状动脉疾病等，将进一步促使心律失常的发生，这可能归因于心房有效不应期的缩短、触发活动及异常自律性的增加，以及传导速度减缓和异质性增加；所有这些作用共同促进了折返性心律失常的维持并可能拉长QT间期。

阻塞性睡眠呼吸暂停低通气综合征；心律失常；机制

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