双水平气道正压通气治疗合并睡眠呼吸暂停综合征的慢性心力衰竭患者的疗效研究

Study of bi-level positive airway pressure in patients with chronic heart failure combined with sleep aprea hypopnea syndrome

目的 观察双水平气道正压通气（BiPAP）对合并睡眠呼吸暂停综合征的慢性心力衰竭患者的治疗效果.方法 将符合标准的入选病例随机分为常规药物治疗组（A组）30例及常规药物＋BiPAP治疗组（B组）30例.所有受试者随访2年并在试验前后分别榆测睡眠呼吸暂停低通气指数（AHI）、夜间血氧饱合度、左室射血分数、脑钠肽、6分钟步行距离及评定心功能分级.结果 试验结束时①B组患者无论是主要终点事件还是次要终点事件均明显少于A组（P＜0.05）.②两组患者主要心力衰竭差数指标均有不同程度改善,但B组改善程度明显优于A组（P＜0.01）.③B组患者AHI、夜间血氧饱合度较治疗前均明显改善（P＜0.05）,而A组患者两者均有恶化趋势.结论 BiPAP对合并睡眠呼吸暂停综合征的慢性心力衰竭患者的治疗效果明确并能改善预后.

Objective Observe the effect of bi-level positive airway pressure （BiPAP） in patients with chronic heart failure combined with sleep apnea hypopnea syndrome（SAHS）. Methods 60 patients were randomly assigned to routine drug therapy group（group A） and routine drug therapy combined with BiPAP group（group B）,30 patients in each group. After 2-year fellow up, apnea hypopnea index（AHI）,nocturnal oximetry,left ventricular ejection fraction, brain natriuretic peptide,6-minute walk test, NYHA difference indicators of heart failure between the two groups were improved in varying degrees, group B AHI, nocturnal oximetry were markedly improved in group B, but the two both were deterioration in group A. Conclusions The effect of BiPAP was evident and can improve the prognosis obviously in patients with chronic heart failure combined with SAHS.