无创正压通气对慢性充血性心力衰竭合并潮式呼吸-中枢性睡眠呼吸暂停的影响  

The effect of noninvasive positive pressure ventilation on patients with chronic congestive heart failure combined with cheyne-stokes respiration and central sleep apnea

作　　者：王梦歌 欧阳松云[1] 孙培宗[1] 

机构地区：[1]郑州大学第一附属医院呼吸睡眠科,河南郑州450052

出　　处：《河南医学研究》2014年第9期8-11,共4页Henan Medical Research

基　　金：河南省科技厅重点攻关项目(122102310218)

摘　　要：目的:探讨无创正压通气(noninvasive positive pressure ventilation,NPPV)治疗对慢性充血性心力衰竭(chronic heart failure,CHF)合并潮式呼吸(cheyne-stokes respiration,CSR)-中枢性睡眠呼吸暂停(central sleep apnea,CSA)患者的影响。方法:回顾性分析67例CHF合并CSR-CSA患者,根据治疗方案不同分为NPPV组(34例)和对照组(33例),对照组单纯行常规抗心衰药物治疗,NPPV组在常规抗心衰药物治疗基础上加用NPPV,治疗6个月复查。结果:1NPPV组治疗前后比较,BMI、ESS评分、呼吸暂停低通气指数(AHI)、微觉醒指数均明显下降(P<0.05);Ⅲ期及快速动眼期睡眠时间、最低血氧饱和度(L-SaO2)明显增加(P<0.05)。2治疗后,NPPV组纽约心功能分级(NYHA)、B型脑钠肽(BNP)均较前降低,左心室射血分数(LVEF)、6 min步行距离较前增加,差异有统计学意义(P<0.05)。结论:对CHF合并CSR-CSA患者,在常规应用抗心衰药物治疗基础上积极采用NPPV治疗,可更大程度地改善心脏功能,值得临床推广应用。Objective：To investigate the effect of noninvasive positive pressure ventilation on pa-tients with chronic congestive heart failure combined with cheyne-stokes respiration and central sleep apnea .Methods：67 patients with CHF combined with CSR-CSA were divided into NPPV group（34 cases） and control group （33 cases） according to the different therapeutic regimens . The NPPV group was treated with standard medications and NPPV , and the control group was trea-ted with standard medications.Results：①NPPV group’s BMI, ESS score, AHI, arousal index after treatment were lower than before treatment （ P〈0.05 ） , lowest oxygen saturation （ L-SaO 2） were increased in Ⅲperiod and not rapid eye movement （ NREM） （ P〈0.05） .②NYHA, BNP of NPPV group was reduced and lower than before treatment （ P〈0.05 ） , LVEF was higher （ P〈0 .05 ） , the difference was statistically significant .Conclusion： For patients with CHF combined with CSR-CSA, NPPV could improve the heart function and deserve the clinical expansion .

关 键 词：慢性充血性心力衰竭 潮式呼吸-中枢性睡眠呼吸暂停 无创正压通气 

分 类 号：R541[医药卫生—心血管疾病]