经鼻面罩持续气道内正压通气对阻塞性睡眠呼吸暂停低通气综合征伴心力衰竭患者心率变异性及心功能的影响研究Impact of Nasal/Face Mask Continuous Positive Airway Pressure Ventilation on Heart Rate Variability and Cardiac Function of Obstructive Sleep Apnea Hypopnea Syndrome Patients Complicated with Heart Failure
肖立平;邓俊国;冯春晖;王涛;孙艳辉;沈新蕾;
摘要(Abstract):
目的探讨经鼻面罩持续气道内正压通气(n CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴心力衰竭(HF)患者心率变异性(HRV)及心功能的影响。方法选取2013—2015年秦皇岛市第二医院收治的OSAHS伴HF患者96例,采用随机数字表法分为对照组45例与观察组51例。在常规药物治疗基础上,对照组患者予以吸氧治疗,观察组患者予以n CPAP治疗;两组患者均连续治疗3个月。比较两组患者治疗前后HRV指标〔24 h窦性R-R间期总体标准差(SDNN)、24 h每5 min平均窦性R-R间期标准差(SDANN)、相邻窦性R-R间期差值的均方根(r MSSD)和相邻R-R间期差值>50 ms百分比(PNN50)〕、睡眠呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(Sa O2)、心功能指标〔左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、氨基末端B型脑利钠肽前体(NT-pro BNP)〕。结果治疗前两组患者SDNN、SDANN、r MSSD、PNN50比较,差异无统计学意义(P>0.05);治疗后观察组患者SDNN、SDANN、r MSSD、PNN50高于对照组(P<0.05)。治疗前两组患者AHI、夜间最低Sa O2比较,差异无统计学意义(P>0.05);治疗后观察组患者AHI低于对照组,夜间最低Sa O2高于对照组(P<0.05)。治疗前两组患者LVEDD、LVEF及NT-pro BNP水平比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEDD小于对照组,LVEF高于对照组,NT-pro BNP水平低于对照组(P<0.05)。结论 n CPAP可有效改善OSAHS伴HF患者HRV,纠正其夜间低氧血症,改善其心功能。
关键词(KeyWords): 睡眠呼吸暂停,阻塞性;心力衰竭;连续气道正压通气;治疗结果
基金项目(Foundation):
作者(Author): 肖立平;邓俊国;冯春晖;王涛;孙艳辉;沈新蕾;
Email:
DOI:
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