以扩张性心肌病为首发表现的睡眠呼吸暂停低通气综合征1例报告并文献复习

Dilated Cardiomyopathy as the First Presentation of Sleep Apnoea/Hypopnoea Syndrome: A Case Report and Review of Literature

目的探讨睡眠呼吸暂停低通气综合征(sleep apnea hypopnea syndrome,SAHS)与扩张性心肌病(dilated cardiomyopathy,DCM)的关系及相关治疗。方法报告1例以DCM为首发表现的SAHS,并进行相关文献复习。结果依据超声心动图检查、标准多导睡眠仪(PSG)监测结果以及其他相关的临床资料本例患者主要诊断为重度SAHS、DCM以及心功能不全Ⅳ级;应用常规药物治疗心力衰竭,同时行联合双水平气道正压(BiPAP:IPAP1.666 kPa,EPAP 0.686 kPa,RR 12次.min-1,S/T模式)治疗,患者夜间呼吸暂停及低通气消失,心功能明显改善(心功能Ⅱ级)。结论 SAHS和DCM具有一定的关系,单纯抗心力衰竭治疗效果不佳,联合BiPAP治疗效果明显。

Objective To investigate the role of sleep apnoea/hypopnoea syndrome（SAHS） in the pathological process of dilated cardiomyopathy（DCM）,and to explore its pathogenesis,diagnosis and therapy.Methods A case of SAHS with DCM as the first presentation was reported and the related literature was reviewed.Results According to the clinical information,results of ultrasonic cardiogram and standard polysomnogram（PSG） monitoring,the patient was diagnosed with severe SAHS,DCM and cardiac insufficiency（class Ⅳ）.After treatment with conventional drugs and bi-level positive airway pressure（BiPAP：IPAP 1.666 kPa,EPAP0.686 kPa,RR 12 beats·min-1,S/T） ventilation,nocturnal apnoea/hypopnoea disappeared and cardiac function was significantly improved（class Ⅱ）.Conclusion SAHS is associated with DCM,and a combination of BiPAP and anti-heart failure therapy should be given to patients with DCM as the first presentation of SAHS.