阻塞性睡眠呼吸暂停综合征并发心力衰竭的综合治疗分析

Comprehensive treatment of obstructive sleep apnea syndrome and heart failure

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)并发心力衰竭的综合疗法。方法通过社区登记、医院临床体检及辅助检查确诊的148例OSAS并发心力衰竭患者根据病情分成轻度组(62例)、中度组(48例)、重度组(38例),对3组患者均采用内科保守治疗及外科手术治疗的综合治疗方式,比较3组患者的临床疗效及治疗前后心功能、血氧饱和度(SaO2)的变化。结果治疗后3组患者收缩压、舒张压、呼吸暂停低通气指数(AHI)、左室射血分数(LVEF)、最长低通气时间、SaO2均明显好转,与治疗前比较,差异有统计学意义(P<0.05);治疗后3组间AHI、最长低通气时间、SaO2差异有统计学意义(P<0.05),且两两组间比较差异有统计学意义(P<0.05),AHI、最长低通气时间、SaO2的改善情况随病情的加重而减弱。轻度组治愈率为51.61%、总有效率为95.16%,中度组治愈率为35.42%%、总有效率为89.58%,重度组治愈率为28.95%、总有效率为78.95%,3组疗效比较差异有统计学意义(χ2=8.659,P<0.05)。结论 OSAS并发心力衰竭的综合治疗效果良好,患者心功能、阻塞性睡眠呼吸暂停改善明显。

Objective To explore the comprehensive treatment of obstructive sleep apnea syndrome （OSAS） and heart failure. Methods 148 cases of patients with OSAS and heart failure diagnosed by community registration,hospital clinical examination and laboratory examinations were divided into mild group （62 cases）,moderate group （48 cases）,severe group （38 cases） according to the disease,the three groups of patients were treated with conservative treatment and surgical treatment.The efficacy and cardiac function,oxygen saturation （SaO2） before and after treatment in three groups were compared. Results After treatment,the systolic blood pressure,diastolic blood pressure,apnea-hypopnea index （AHI）,left ventricular ejection fraction （LVEF）,longest hypopnea time,SaO2 in three groups were improved,compared with before treatment,the difference was significant （P〈0.05）;the difference of the AHI,longest hypopnea time,SaO2 between three groups was significant （P〈0.05）,the difference between the two groups was significant （P〈0.05）.In mild group,the cure rate was 51.61%,the total effective rate was 95.16%;in moderate group,it was 35.42% and 89,58% respectively;in severe group,it was 28.95% and 78.95% respectively;the efficacy of three groups had significant difference （x^2=8.659, P〈0.05）. Conclusion The comprehensive treatment efficacy of OSAS and heart failure is well,the improvement of cardiac function and obstructive sleep apnea is significant.