目的：研究阻塞性睡眠呼吸暂停/低通气综合征(OSAHS)患者动态心电图心率变异性(HRV)长、短时程频域指标，窦性心率震荡(HRT)，T波电交替(TWA)，T波顶点-T波终末时间间期(TpTe)及其离散度(TpTed)等的特点。 方法：选取102例于我院睡眠中心就诊，临床疑诊阻塞性睡眠呼吸暂停/低通气综合征的患者，均行多导睡眠监测(PSG)，根据监测结果分为OSAHS(+)组及OSAHS(-)组，并根据OSAHS(+)组AHI的4分位间距将OSAHS(+)组分为4个亚组进行研究。同时对入选患者行同步12导联动态心电图监测，获得HRV长、短时程频域指标，HRT，TWA，TpTe及TpTed等相关指标。比较OSAHS(+)组和OSAHS(-)组之间上述指标是否存在差异，以及探讨上述动态心电图指标与OSAHS病情严重程度之间的相关性。 结果：与OSAHS(-)组相比，OSAHS(+)组体重(P=0.000)、 BMI(P=0.001)、EES 评分(P=0.007)、清醒时收缩压(P=0.019)、睡眠后收缩压(P=0.012)、睡眠后舒张压(P=0.018)及睡眠后平均压(P=0.007)增高，夜间最低血氧饱和度降低(P=0.000)；其中夜间最低血氧饱和度与AHI呈负相关(R=0.702，P=0.000)， EES评分与AHI呈正相关(R=0.322，P=0.037)。动态心电图相关指标中，OSAHS(+)组与OSAHS(-)组相比，夜间睡眠HRV长时程频域指标LF/HF增加，且与AHI呈正相关(R=0.422， P=0.000)；短时程频域指标中，清醒时HF降低，与AHI呈负相关(R=0.416，P=0.000)；清醒时LF/HF比值增高，与AHI呈正相关(R=0.217，P=0.037)，睡眠后LF/HF比值增高，与AHI呈正相关(R=0.320，P=0.002)。此外，OSAHS(+)组HRV短时程频域指标HF、LF及VLF，经过整夜睡眠后与清醒时相比呈整体增高趋势，P均为0.000。有关HRT指标的结果表明，在各分组之间HRT并无显著差别。有关TWA指标的结果表明，按照OSAHS病情严重程度分组之间的横向比较，TWA各指标间的差异并不明显；但对于病情严重者(按照AHI 4分间距分组的第四4 分间距组)TWA60 (P=0.022)、TWA 120 (P=0.024)、TWA 180 (P=0.008)及TWA均值(P=0.021)经过睡眠后与清醒时比较显著增高。OSAHS(+)组与OSAHS(-)组相比，其睡眠后的TpTe升高(P=0.010)。对睡眠后血压是否升高进行logistics回归分析(采用后退法)，结果表明睡眠后VLF与睡眠后血压增高呈正相关(95% CI 1.0000607～1.000301，P=0.003)，夜间最低血氧饱和度与睡眠后血压增高呈负相关(95% CI 0.895～0.983，P=0.007)。对是否罹患OSAHS进行logistics回归分析(采用后退法)，夜间低血氧饱和度是罹患OSAHS的危险因素(95%CI 0.052～0.650， P=0.009)；同时，体重增加是0SAHS的危险因素(95% CI 1.005～3.190，P=0.048)；但BMI增大并不是OSAHS患病的危险因素，相反，BMI越大，罹患OSAHS的风险越小(95% CI 0.037～0.956，P=0.044)；各种动态心电图指标与OSAHS患病之间无明显相关性。 结论：OSAHS患者动态心电图指标中HRV长时程频域指标、短时程频域指标、TWA及TpTe存在异常，并可在一定程度上反映OSAHS的严重程度。部分指标可以良好的反映OSAHS患者自主神经系统的变化，并与血压变化具有良好的相关性。 [关键词]睡眠呼吸暂停/低通气综合征(OSAHS)，动态心电图，心率变异性，短时程频域指标，窦性心率震荡，T波电交替，TpTe间期，TpTe离散度。

 Objective: To investigate the characteristics of Holter parameters (including long - term and short - term frequency -domain indicators of heart rate variability, heart rate turbulence, T wave alternans, T peak - end interval and T peak - end interval dispersion) in patients with obstructive sleep apnea /hypopnea syndrome. Methods: A total number of 102 patients who had undergone both PSG and Holter were enrolled into this study. They were divided into OSAHS positive group and OSAHS negative group, and the OSAHS positive group was classified into quartiles of AHI score. The long - term and short - term frequency - domain indicators of heart rate variability, heart rate turbulence, T wave alternans, T peak - end intervals and T peak - end interval dispersion were detected. The parameters of OSAHS positive and negative group were compared, then the relationships of these parameters and the severity of the disease were investigated. Results: The body weight, BMI, EES score and levels of blood pressure in OSAHS patients were significantly higher ,the lowest nocturnal oxygen saturation were significantly lower than that in the OSAHS negative group (P＜0.05) . There was apparent negative correlation between the lowest nocturnal oxygen saturation and AHI score(R=0.702, P=0.000), and apparent positive correlation between the EES score and AHI score (R= 0.322, P=0.037) . The parameters of long - term frequency - domain indicator LF/HF in OSAHS patients were significantly higher than that in the OSAHS negative group, and had a strong positive correlation with the AHI score (P＜0.05). The parameters of awake short - term frequency - domain indicators HF were significantly lower and the awake LF/HF were significantly higher in OSAHS patients, both of the tow parameters had strong correlation with the AHI score (P＜0.05). In addition, the short - term frequency - domain parameters including HF,LF and VLF increased after the whole night sleep in the OSAHS positive group(P＜0.05). There' re no significant differences in HRT parameters between OSAHS positive group and OSAHS negative group. For the fourth quartile group of OSAHS patients, TWA increased after the whole night sleep. TpTe were significant higher in the OSAHS positive group compared to the OSAHS negative group (P＜0.05). Logistics regression analysis (backward method) results showed that low nocturnal oxygen saturation was the risk factor for both hypertension and OSAHS (P＜0.05), the Holter parameter VLF post-sleep was positively related to blood pressure increase (P＜0.05), obesity was the risk factor for OSAHS (P＜0.05). Conclusions: The Holter parameters (including long-term and short-term frequency-domain indicators of heart rate variability, heart rate turbulence, T wave alternans, T peak-end intervals and T peak-end interval dispersion) in patients with obstructive sleep apnea / hypopnea syndrome were abnormal, and the parameters can reflect the severity of the disease to some extent. Some of the parameters can also reflect changes of the autonomic nervous system, and had good correlation with blood pressure fluctuations . [Keywords] Obstructive Sleep Apnea/Hypopnea Syndrome , Holter , HRV , short-term frequency-domain indicators , HRT , TWA, TpTe/TpTed.