无创正压通气对冠心病合并阻塞性睡眠呼吸暂停低通气综合征患者血管内皮功能与心功能的影响  

Effect of Continuous Positive Airway Pressure Therapy on Vascular Endothelial Function and Heart Function in Coronary Heart Disease Patients Combined with Obstractive Sleep Apnea-hypopnea Syndrome

作　　者：张世袍[1] 杨阳[1] 陈建平 乐兴丁[1] 刘仁骧 

机构地区：[1]福建中医药大学第五临床医院三明市第二医院心内科,福建省永安市366000

出　　处：《医学理论与实践》2017年第23期3454-3456,共3页The Journal of Medical Theory and Practice

基　　金：三明市科技计划项目(NO:2014-S-3)

摘　　要：目的:探讨无创正压通气(CPAP)治疗对冠心病(CHD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血管内皮功能与心功能的影响。方法:选取CHD合并OSAHS的患者80例,按照治疗方法的不同分为对照组与治疗组,每组40例,对照组按照CHD指南标准治疗,治疗组在标准治疗的基础上给予CPAP治疗,随访观察3个月,于入院第1天、3个月后分别检测NT-proBNP、VEGF、vWF水平,超声心动图测量LAD、LVEDD、LVEF、FS变化,多导联睡眠系统记录AHI、夜间最低血氧饱和度、平均血氧饱和度、睡眠过程清醒时间、清醒次数、血氧饱和度低于90%时间所占百分比(TST SaO2<90%)等睡眠指标的变化。结果:随访3个月后发现:治疗组患者VEGF、vWF、NT-proBNP、LAD、LVEDD水平较对照组均明显降低,LVEF、FS水平较对照组明显升高,差异有统计学意义(均P<0.05);治疗组AHI、TST SaO2<90%、睡眠过程清醒时间、清醒次数等指标较对照组明显降低,夜间最低血氧饱和度、平均血氧饱和度较对照组明显升高,差异有统计学意义(均P<0.05)。结论:无创正压通气治疗能显著改善冠心病合并OSAHS患者血管内皮功能、心脏功能及睡眠质量。Objective：To investigate the effect of continuous positive airway pressure therapy on vascular endothelial function and heart function in coronary heart disease patients combined with obstractive sleep apnea-hypopnea syndrome.Methods：A total of 80 patients with coronary heart disease patients combined with obstractive sleep apnea-hypopnea syndrome were selected for the study.There were randomized into control group and treatment group.The patients in the control group received routine treatment.The patients in the control group received routine treatment with continuous positive airway pressure therapy.The levels of NT-proBNP,VEGF,vWF in the first day and three months after the treatment were examined by Enzyme linked immunosorbent assay.the LAD,LVEDD,LVEF,FS were examined by Ultrasonic echocardiograph.The related indicators of sleep were examined by PSG.Results：Compared with the control group,the levels of NT-proBNP,VEGF,vWF,LAD,LVEDD,AHI,TST SaO290%,the sleep prpcess awake time,awake times were significantly decreased,the LVEF,FS,minimum oxygen saturation,agerage oxygen saturation were significantly increased（All P〈0.05）.Conclusion：Continuous positive airway pressure therapy may significantly improve the vascular endothelial function,heart function and the sleep quality in patients in coronary heart disease patients combined with obstractive sleep apnea-hypopnea syndrome.

关 键 词：冠心病 OSAHS 正压无创机械通气 血管内皮细胞功能 心功能 

分 类 号：R541[医药卫生—心血管疾病]