经鼻持续气道正压通气治疗睡眠呼吸暂停综合征合并冠心病心律失常临床研究  

Nasal continuous positive airway pressure in treatment of obstructive sleep apnea/hypopnea syndrome with coronary heart disease and cardiac arrhythmia

作　　者：赵军[1] 郝芙蓉[2] 张芳[1] 汪贺媛[3] 孙逊[4] 

机构地区：[1]石家庄市第一医院心内科,河北石家庄050011 [2]河北医科大学第二医院耳鼻喉科,河北石家庄050000 [3]石家庄市第一医院耳鼻喉科,河北石家庄050011 [4]白求恩国际和平医院呼吸内科,河北石家庄050082

出　　处：《临床荟萃》2009年第2期99-101,共3页Clinical Focus

基　　金：河北省科学技术研究与发展指导计划项目(0627611093)

摘　　要：目的初步探讨经鼻持续气道正压通气(nCPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并冠心病心律失常患者的疗效和机制。方法选择OSAHS合并冠心病心律失常患者252例,随机分为两组,实验组126例在药物治疗基础上加用nCPAP治疗,对照组126例仅为药物治疗,疗程均为3个月,观察两组治疗效果。结果实验组治疗后与对照组比较,呼吸暂停低通气指数(AHI)明显下降15.2±3.3 vs 52.5±14.3(P<0.01),TSTSaO2<90%明显下降(16.7±4.6)%vs(67.5±11.4)%(P<0.01),夜间最快心率明显下降(86.3±15.2)次/min vs(106.3±16.01)次/min(P<0.05),SaO2low明显升高(87.5±6.3)%vs(58.4±10.9)%(P<0.05),夜间最慢心率明显升高(60.2±10.1)次/min vs(47.4±9.8)次/min(P<0.05),夜间心律失常发生次数明显减少(19.6±9.4)次/min vs(62.5±19.6)次/min(P<0.01)。结论nCPAP治疗可以消除呼吸暂停,纠正低氧血症,减少夜间心律失常发生次数,从而降低心血管终点事件发生率。Objective To observe the effect and mechanism of nasal continuous positive airway pressure （nCPAP） in the treatment of obstructive sleep apnea/hypopnea syndrome（OSAHS） with coronary heart disease and cardiac arrhytbmia. Methods Altogether 252 OSAHS patients with coronary heart disease and arrhythmia were randomly divided into two groups. Treatment group was treated by nCPAP on the basis of medicine but control group by former methods. Three months later, polysomnography（PSG）, Hoher ECG were measured. Results After three months,contrast with control group, nCPAP therapy in OSAHS with coronary heart disease and arrhythmia showed decrease in AHI 15.2±3.3 vs 52.5± 14.3,TSTSaO2 〈90%（16.7±4.6） % vs （67.5± 11.4）% and max heart rate （86.3±15.2） beats/min vs （106.3 ± 16.01） beats/min （ P 〈0.05 or P 〈0.01）, but increase in SaO2low （87.5 ± 6.3）% vs （58.4±10.9）% and min heart rate （60.2±10.1） beats/min vs （47.4±9.8） beats/min （ P 〈0.05） ,the time of cardiac arrhythmia was shortened significantly （ P 〈0.01）. Conclusion nCPAP may abolish sleep apnea and hypopnea, correct hypoxemia, shorten the time of cardiac arrhythmia, decrease the frequency of cardiac matter significantly.

关 键 词：睡眠呼吸暂停 阻塞性 心律失常 连续气道正压通气 多道睡眠描记术 

分 类 号：R56[医药卫生—呼吸系统] R541.7[医药卫生—内科学]