nCPAP治疗老年慢性心力衰竭伴阻塞性睡眠呼吸暂停低通气综合征患者分析

Therapeutic Effect of Nasal Continuous Positive Airway Pressure on Elderly Patients with Chronic Heart Failure and Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨经鼻持续气道正压通气(nCPAP)治疗老年慢性心力衰竭(CHF)伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的疗效。方法将39例经多导睡眠图(PSG)检测筛选出来的老年慢性心力衰竭患者,根据睡眠呼吸暂停低通气指数(AHI)将研究组分为:轻中度组18例(AHI≤30)和重度组21例(AHI>30)。采用nCPAP呼吸机每晚7～9h的治疗,持续12周,比较治疗前后AHI最低动脉血氧饱和度(SaO2)、平均SaO2最长低通气时间,左室舒张末期内径(LVDd)、左室射血分数(LVEF)、B型尿钠肽值(BNP)以及血液流变学指标的变化。结果在使用nCPAP治疗12周后,AHI、最长低通气时间显著低于治疗前,最低SaO2和平均SaO2则显著上升,LVDd、LVEF、BNP以及血液流变学指标均有显著改善。结论 nCPAP治疗不仅可以改善呼吸暂停和低通气,纠正低氧血症,还能改善心力衰竭。

Objective To explore the therapeutic effect of nasal continuous positive airway pressure（nCPAP）on elderly patients with chronic heart failure （CHF） and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Thirty-nine elderly patients with chronic heart failure were selected by polysomnography（PSG） test, and according to apnea hypopnea index（AHI）,were divided into mild to moderate SAHS groups（AHI≤30,n=18） and severe SAHS group（AHI〉30,n=21 ）. All patients were treated by nCPAP 7 to 9 h every night. After 12- week treatment, the AHI, lowest arterial oxygen saturation （SaO2）, mean SaO2 longest hypopnea time,left ventricular end diastolic dimension （LVDd）, left ventricular ejection fraction （LVEF）,B-type natriuretic peptide value （BNP） and blood rheology indicators were detected. Results After 12-week treatment of nCPAP, the AHI, the longest hypopnea time, the lowest SaO2, mean SaO2, LVDd, LVEF, BNP and blood rheology indicators were significant improved. Conclusion nCPAP therapy not only can improve apnea and hypopnea, correct hypoxemia but improve heart failure as well.