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2019 年第 2 期 第 14 卷

慢性心力衰竭合并阻塞性睡眠呼吸暂停低通气综合征患者经鼻持续气道正压通气治疗效果分析

Therapeutic effect of nasal continuous positive airway pressure on chronic heart failure complicated with obstructive sleep apnea hypopnea syndrome

作者:郭建梅赵季红

英文作者:

单位:300162天津,中国人民武装警察部队特色医学中心干部病房

英文单位:

关键词:慢性心力衰竭;阻塞性睡眠呼吸暂停低通气综合征;持续气道正压通气

英文关键词:

  • 摘要:
  • 【摘要】

    【摘要】目的    探讨慢性心力衰竭合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者经鼻持续气道正压通气(CPAP)治疗效果。方法    选择2015年6月至2017年11月在武装警察部队后勤学院附属医院住院确诊为慢性心力衰竭合并OSAHS患者108例,按照随机数字表法分为观察组(60例)和对照组(48例)。对照组患者仅给予常规基础药物治疗,观察组患者在对照组基础上接受CPAP治疗,2组均治疗12周。比较2组患者治疗前后呼吸睡眠监测参数[睡眠呼吸暂停低通气指数(AHI)、平均呼吸暂停时间(MAT)、平均动脉血氧饱和度(MSaO2)]、超声心动图观察指标[左心房内径(LA)、左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPW)及左心室射血分数(LVEF)]和B型脑钠肽(BNP)水平。结果    治疗前,2组患者各项指标比较,差异均无统计学意义(均P>0.05)。治疗后,观察组患者AHI、MAT、LA、LVEDD、LVPW、BNP水平明显低于治疗前和对照组[(7.4±2.9)次/h比(52.5±13.1)、(51.8±10.4)次/h;(7±4)s比(46±8)、(47±7)s;(39±4)mm比(42±5)、(41±5)mm;(49±3)mm比(54±4)、(54±4)mm;(8.7±1.4)mm比(11.3±1.7)、(10.3±1.5)mm;(194±70)ng/L比(401±90)、(409±80)ng/L],MSaO2、LVEF明显高于治疗前和对照组[(93.3±1.8)%比(79.7±3.7)%、(81.2±4.1)%;(51±4)%比(45±9)%、(45±6)%](均P<0.05)。结论    CPAP治疗慢性心力衰竭合并OSAHS患者能纠正缺氧情况,改善心功能。

  • 【Abstract】Objective    To observe the effect of nacal continuous positive airway pressure (CPAP) on patients with chronic heart failure(CHF) complicated with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods    A total of 108 CHF with OSAHS patients admitted to Affiliated Hospital of Logistics University of Chinese People′s Armed Police Forces from June 2015 to November 2017 were randomly divided into observation group(n=60) and control group(n=48). The control group was treated with conventional medication; the observation group was treated with CPAP on the basis of coventional medication; all patients were treated for 12 weeks. Apnea hypopnea index(AHI), mean apnea time(MAT), mean arterial oxygen saturation (MSaO2), left atrial diameter(LA), left ventricular end-diastolic dimension (LVEDD), left ventricular posterior wall thickness(LVPW), left ventricular ejection fraction(LVEF) and brain natriuretic peptide(BNP) were analyzed. Results    Before treatment, there was no significant difference in sleep monitoring parameters and echocardiographic parameters between groups(P>0.05). After treatment, AHI, MAT, LA, LVEDD, LVPW, BNP in the observation group were significantly lower than those before treatment and those in the control group[(7.4±2.9)times/h vs (52.5±13.1),(51.8±10.4)times /h; (7±4)s vs (46±8),(47±7)s; (39±4)mm vs (42±5),(41±5)mm; (49±3)mm vs (54±4),(54±4)mm; (8.7±1.4)mm vs (11.3±1.7),(10.3±1.5)mm; (194±70)ng/L vs (401±90),(409±80)ng/L]; MSaO2 and LVEF in the observation group were significantly higher than those before treatment and those in the control group[(93.3±1.8)% vs (79.7±3.7)%,(81.2±4.1)%; (51±4)% vs (45±9)%, (45±6)%](all P<0.05). Conclusion    CPAP can improve hypoxia and cardiac function in patients with CHF and OSAHS.

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