慢性充血性心力衰竭患者伴睡眠呼吸暂停综合征的临床研究  

Clinical Study on Congestive Heart Failure patients with Sleep Apnea Syndrome

作　　者：赖旭东[1] 李炳流[2] 

机构地区：[1]广州市红十字会医院急诊科,510220 [2]广州医学院第二附属医院急诊科,510220

出　　处：《中国临床实用医学》2010年第5期118-119,共2页China Clinical Practical Medicine

摘　　要：目的探讨慢性充血性心力衰竭（CHF）伴睡眠呼吸暂停综合征（SAS）患者对心功能能响及其血清瘦素（1eptin）水平和肿瘤坏死因子a（TNF—a）的变化与临床意义。方法22例心力衰竭扈（CHF组）和18例心力衰竭伴睡眠呼吸暂停综合征患者（CHF＋SAS组），进行多导睡眠图（PSG）检查;抽取静脉血测定血清瘦素（放射免疫法）及TNF—a，sTNFR1水平（ELISA法）。结果①CHF＋SAS缍眠呼吸暂停低通气指数（AHI），SpO2〈90％的时间占总睡眠时间的百分数（TSaO2〈90％）均显著高CHF组（P〈0．01）；②CHF＋SAS组血清瘦素水平及TNF-a，sTNFR1水平显著高于CHF组（P〈0．01）结论慢性充血性心力衰竭伴睡眠呼吸暂停综合征患者反复的夜间血氧饱和度降低可加重病情，血瘦素及TNF-a可能参与上述的发病过程。Objective To investigate the effect of sleep apnea syndrome（SAS）on the cardiac function of congestive heart failure（CHF） patients, and the clinical significance of leptin and tumor necrosis factor a （TNF-a）in serum. Methods 22 patients with congestive heart failure only（ CHF group）and 18 patients with congestive heart failure and sleep apnea syndrome （CHF ＋ SAS group）were examined with the Polysomnogram （PSG）, their serum were tested on the levels of leptin（ by radio-immunoassay）, TNF-a and sTNFR1 （by ELISA method）. Results ①The AHI（ apnea hypopnea index） and the TSaO2 〈90% （ the time of SpO2〈90% in total sleeping time）in C HF ＋ SAS group are significantly higher than those in CHF group（ P 〈 0. 01 ）.②The level of Leptin,TNF-a and sTNFR1 in CHF ＋ SAS group are significantly higher than those in CHF group（P 〈0. 01 ）. Conclusion The sleep apnea syndrome cause the blood oxygen desaturation at night,it makes the patients with congestive heart failure getting worse. Leptin and TNF-a might involve in this disease development.

关 键 词：心力衰竭 睡眠呼吸暂停综合征 瘦素 肿瘤坏死因子 

分 类 号：R766[医药卫生—耳鼻咽喉科]