持续气道正压通气对合并阻塞性睡眠呼吸暂停低通气综合征的功能性良性快速性心律失常患者的疗效研究  

Continuous positive airway pressure treatment for functional cardiac arrhythmias combined with obstructive sleep apnea hypopnea syndrome

作　　者：刘剑勇[1] 陆建斌 李梦琳[1] 徐跃[1] 杨琪[1] 袁毅方 余艳[1] 叶京英[2] 

机构地区：[1]江苏省张家港市第一人民医院耳鼻咽喉科,215600 [2]首都医科大学附属同仁医院耳鼻咽喉头颈外科,100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第3期221-224,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：江苏张家港市市级科研课题（ZKS1219）

摘　　要：目的 探讨持续气道正压通气（CPAP）治疗对合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的功能性心律失常患者的疗效.方法 收集2012年9月至2013年6月期间在江苏省张家港市第一人民医院睡眠呼吸障碍与鼾症监测中心就诊的56例合并OSAHS的功能性心律失常患者,用完全随机分组分为两组,对照组28例由心内科医师根据诊疗指南行美托洛尔药物治疗,试验组28例根据呼吸紊乱指数（AHI）分为轻度、中度、重度3组,在用美托洛尔对症治疗的同时行CPAP治疗.监测治疗前后的睡眠呼吸情况及动态心电图比较组间及亚组间差异性.组间比较采用t检验,同组治疗前后比较采用配对t检验.率的比较采用卡方检验,P＜0.05为差异有统计学意义.结果 两组患者一般情况差异无统计学意义,治疗后试验组和对照组显效率分别为57.1％和17.9％,差异有统计学意义（Х^2=7.62,P＜0.01）;总有效率分别为85.7％和53.6％,差异有统计学意义（Х^2=5.41,P＜0.05）.试验组轻度、中度、重度3组患者治疗后AHI及最低血氧饱和度较治疗前差异均有统计学意义（P值均＜0.05）.结论 对于合并OSAHS的功能性心律失常患者CPAP治疗不仅可以有效消除呼吸紊乱指数,改善夜间缺氧症状,而且能有效地提高功能性心律失常的治疗效果.Objective To discuss the effect of continuous positive airway pressure （CPAP）treatment for functional cardiac arrhythmias combined with obstructive sleep apnea hypopnea syndrome.Methods Fifty-six OSAHS patients combined functional cardiac arrhythmia were randomized divided into two groups.The 28 patients in the control group were treated with metoprolol according to cardiac guidelines,the other 28 cases in the experimental group were treated with CPAP therapy combined with metoprolol.AHI and the lowest oxygen saturation （LSaO2） were tested before and after treatment.Results The efficiency rates were 57.1% and 17.9% in experimental and control group respectively,with statistical difference（Х^2=7.62,P 〈 0.01）.Total effective rates were 85.7% and 53.6%respectively,with statistical difference（Х^2=5.41,P 〈 0.05）.In the experimental group,there were three treatment subgroups.After treatment,AHI and the lowest oxygen saturation were significantly different （P 〈0.05）.Conclusion CPAP treatment can effectively eliminate respiratory disturbance index,improve the symptoms of hypooxygen at night,and effectively improve the therapeutic effect of （f）unctional cardiac arrhythmias in OSAHS patients combined with functional arrhythmia.

关 键 词：睡眠呼吸暂停 阻塞性 心律失常 多道睡眠描记术 高频通气 

分 类 号：R766[医药卫生—耳鼻咽喉科] R541.7[医药卫生—临床医学]