长期持续气道正压通气治疗对右心室收缩功能及右心室重构的影响  

Effect of Long Term Continuous Positive Airway Pressure Treatment on Right Ventricular Function and Remodeling

作　　者：夏晓虹[1] 姬琛华[1] 刘永华[1] 苏德淳[2] 毋健[2] 

机构地区：[1]大连市中心医院急诊综合科,辽宁省116033 [2]大连医科大学附属第一医院心力衰竭科

出　　处：《中国循环杂志》2015年第3期260-263,共4页Chinese Circulation Journal

摘　　要：目的:观察长期持续气道正压通气治疗对右心室收缩功能及右心室重构的影响。方法:选取阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者24例。采用心尖四腔心切面测量右心室收缩末期面积(RVESA)、右心室舒张末期面积(RVEDA)并计算右心室面积变化率(RVFAC),测量等容收缩期加速度(IVA)。在三尖瓣环水平处测量右心室游离壁(RVW)的收缩期峰值速度(SMRVW)及右心室游离壁三尖瓣环收缩期位移(TAPSE)。依据呼吸暂停低通气指数(AHI),将OSAHS患者分为OSAHS中度组l6例(15次/小时<AHI<30次/小时),OSAHS重度组8例(AHI>30次/小时)。结果:OSAHS患者持续气道正压通气治疗6个月后,RVFAC、SMRVW、IVA、TAPSE较治疗前增加,RVESA、RVEDA较治疗前减小(P<0.01或P<0.05),差异均有统计学意义;OSAHS中度组患者在持续气道正压通气治疗6个月后,RVFAC、SMRVW、IVA、TAPSE较治疗前增加,RVESA、RVEDA较治疗前减小(P<0.01或P<0.05);OSAHS重度组患者在持续气道正压通气治疗6个月后,RVESA、RVEDA较治疗前减小(P<0.05),差异均有统计学意义。结论:长期持续气道正压通气治疗可以改善OSAHS患者右心室收缩功能及右心室重构,对于OSAHS中度患者改善更为显著。Objective： To observe the effect of long term continuous positive airway pressure （CPAP） treatment on right ventricular systolic function and remodeling. Methods： A total of 24 patients with obstructive sleep apnea hypopnea syndrome （OSAHS） were studied. The right ventricular end systolic area （RVESA）, right ventricular end dilated area （RVEDA） were measured and right ventricular fractional area change （RVFAC） was calculated. The tissue Doppler imaging parameters of isovolumic myocardial acceleration （IVA） and SMRvw. TAPSE were measured. According to apnea hypopnea index （AHI） the patients were classified into 2 groups： Moderate OSAHS group, the patients with （15/h〈AHI〈30/h）, n=16 and Severe OSAHS group, the patients with （AHI〉30/h）, n=8. All patients were treated by CPAP for 6 months, the above parameters were compared at before and after treatment. Results： With 6 months of CPAP treatment, OSAHS patients had increased RVFAC, SMRVW. IVA, TAPSE and decreased RVESA, RVEDA, P〈0.01 or P〈0.05. With 6 months of treatment, the patients in Moderate OSAHS group showed increased RVFAC, SMRVW. IVA, TAPSE and decreased RVESA, RVEDA, P〈0.01 or P〈0.05; the patients in Severe OSAHS group presented decreased RVESA and RVEDA, P〈0.05. Conclusion： Long term CPAP treatment may improve right ventricular systolic function and remodeling, the patients with moderate OSAHS are more beneficial.

关 键 词：右心室重构及功能 持续气道正压通气 组织多普勒 

分 类 号：R541[医药卫生—心血管疾病]