连续气道正压通气对阻塞性睡眠呼吸暂停患者血流动力学的影响  

Influence of continuous positive airway pressure on hemodynamics of patients with obstructive sleep apnea

作　　者：王合金[1] 阳书坤[1] 孙艳芬[1] 徐福琴[1] 

机构地区：[1]深圳市龙岗区人民医院,广东深圳518172

出　　处：《中国医药导报》2012年第3期54-56,共3页China Medical Herald

摘　　要：目的利用无创血流动力监测系统评估阻塞性睡眠呼吸暂停综合征(OSAS)患者血流动力学变化;评估连续气道正压通气(CPAP)对患者血流动力学的作用。方法选择OSAS患者65例和健康对照组35例,使用无创胸电生物阻抗法分别测定所有受试者血流动力学参数。对OSAS患者使用CPAP治疗6个月和9个月后再次评估其血流动力学参数。结果与对照组相比,OSAS组患者心脏指数[(3.8±0.8)L/(min.m2)vs(3.9±0.6)L/(min.m2)],心搏指数[(48.6±17.5)mL/m2 vs(55.4±15.9)mL/m2]和左室射血时间[(280.6±103.2)ms vs(310.3±98.9)ms]值均低于对照组(均P<0.05),其平均动脉压[(100.1±20.5)mm Hg vs(90.5±15.6)mm Hg(1 mm Hg=0.133 kPa)]、系统血管阻力[(1 259.3±258.8)Dyns/cm5 vs(950.9±110.7)Dyns/cm5]、系统血管阻力指数[(1 982.8±481.7)Dyns m2/cm5 vs(1 683.5±301.9)Dynsm2/cm5]均高于对照组(均P<0.05)。与治疗前相比较,经CPAP治疗后6个月后,OSAS系统血管阻力和系统血管阻力指数下降(P<0.05);经CPAP治疗9个月后,OSAS患者血流动力学监测测参数均改善(均P<0.05)。结论OSAS患者早期已存在全身血流动力学异常,与低氧血症密切相关;CPAP能够改善患者血流动力学监测指标。Objective Through the non-invasive hemodynamic monitoring system,to evaluate the hemodynamics changes of patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the influence of continuous positive airway pressure（CPAP） on the hemodynamics of patients.Methods 65 patients with OSAS and 35 healthy person were selected.The non-invasive thoracic electrical bio-impedance method was used to measure the hemodynamic parameters of all the subjects.The hemodynamic parameters of patients with OSAS were reevaluated 6 and 9 months after CPAP treatment.Results Compared with patients of the control group,those of the OSAS group were significantly lower in the cardiac index [（3.8±0.8）L/（min·m2） vs（3.9±0.6）L/（min·m2）],cardiac index [（48.6±17.5）mL/m2 vs（55.4±15.9）mL/m2] and left ventricular ejection time [（280.6±103.2）ms vs（310.3±98.9）ms] values（all P 0.05）;and were significantly higher in the mean arterial pressure [（100.1±20.5）mm Hg vs（90.5±15.6）mm Hg（1 mm Hg=0.133kPa）],systemic vascular resistance [（1 259.3±258.8）Dyns/cm5 vs（950.9±110.7）Dyns/cm5] and systemic vascular resistance index [（1 982.8±481.7）Dyns m2/cm5 vs（1 683.5±301.9）Dyns m2/cm5] values（all P 0.05）.Compared with those before treatment,after six months of CPAP treatment,the systemic vascular resistance and systemic vascular resistance index of patients with OSAS significantly decreased（P 0.05）,and after 9 months of CPAP treatment,the hemodynamic monitoring parameters of patients with OSAS all improved（all P0.05）.Conclusion Patients with OSAS have systemic hemodynamic abnormalities in the early stage,which is closely related to hypoxemia.CPAP can improve the patients＇ hemodynamic monitoring indicators.

关 键 词：睡眠呼吸暂停综合征 血流动力学 连续气道正压通气 

分 类 号：R563.9[医药卫生—呼吸系统]