OSAS患者右心室变化及CPAP对右心室影响的研究

Changes of the pulmonary circulation of right ventricle among OSAS patients and the influences of CPAP on the pulmonary circulation

目的 了解睡眠呼吸暂停综合征 (OSAS)患者右心室病理生理改变 ,及持续气道正压通气 (CPAP)治疗对患者右心室的影响。方法 正常人 96人 ,OSAS患者 96例 ,并随机分成治疗组与对照组 ,一组 OSAS患者经 CPAP治疗 2年 ,另一组 OSAS未给予相同治疗 ,利用彩色多普勒超声系统测量正常人组实验开始时及 96例 OSAS患者开始及两年后右室前壁厚度 (RVT)、肺动脉收缩压 (PASP)、肺动脉舒张压 (PADP)、右室舒张期内径 (DDRV)、右室收缩期内径 (SDRV)、右室射血分数 (REF)、肺动脉流速(PAF)。比较正常人组与 96例 OSAS患者各指标差异显著性。两组间所有指标差异均有统计学意义。结论 OSAS患者肺循环有明显病理性改变 ,表现为右心室变厚 ,右心室内径增大、射血分数降低、肺动脉压升高等系列改变。长期 CPAP治疗后 ,这种病理生理改变较对照组停止 ,提示 CPAP对 OSAS患者的心脏结构及功能有保护作用。

Objectives To understand pathologic changes of the pulmonary circulation among OSAS patients and the influence of CPAP on pulmonary circulation.Method Ninety-six healthy volunteers and 96 OSAAAAS patients participated the study. The 96 OSAS patients were randomly divided into two groups: one group was treated with CPAP for two years and the control group did not receive any treatment.Results For all subjects, Doppler echo cardiography was used and the measures of pulmonary circulation indexes included the following: right ventricle front wall thickness (RVT), pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), right ventricle dimension at diastolic period (DDRV), right ventricle dimension at systolic period (SDRV), the right ventricle EF (RED), and pulmonary artery velocity of flow (PAD). All above-mentioned measures were shown significant differences between the two groups.Conclusions For OSAS patients, pathologic changes were shown in pulmonary circulation, which included the thickened right ventricle, enlarged dimension, increased pulmonary artery pressure, and reduced EF.A long time treatment with CPAP has effects on the pathologic changes, which suggests that CPAP may be useful in protecting the structure and function of the right ventricle.