无创正压通气对老年心力衰竭合并阻塞性睡眠呼吸暂停综合征疗效分析

Analysis of the efficacy of noninvasive positive pressure ventilation in elderly patients with heart failure complicated by obstructive sleep apnea syndrome

目的研究无创正压通气对老年心力衰竭合并阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者的治疗效果。方法采用随机数表法将本院2016年4月至2017年4月收治的119例心力衰竭合并OSAS老年患者分为观察组(60例)和对照组(59例)。在常规药物治疗基础上,观察组患者采用无创正压通气,对照组患者采用低流量吸氧治疗。比较两组患者的睡眠质量、血红蛋白、红细胞、促红细胞生成素、B型脑钠肽原(pro-brain natriuretic peptide,pro-BNP)水平及血压。结果治疗后,观察组患者的血红蛋白、红细胞、促红细胞生成素、pro-BNP水平、血压及睡眠呼吸暂停低通气指数均明显低于本组治疗前及同期对照组水平,而夜间最低动脉血氧饱和度高于本组治疗前及同期对照组水平(P<0.05)。观察组患者对睡眠质量的总体满意度显著高于对照组(P<0.05)。结论无创正压通气可显著改善心力衰竭合并OSAS老年患者的血氧饱和度和睡眠质量,降低pro-BNP水平。

Objective To explore the treatment effect of noninvasive positive pressure ventilation in elderly patients with heart failure complicated by obstructive sleep apnea syndrome（OSAS）. Method A total of 119 elderly patients with heart failure combined with OSAS admitted in our hospital from April 2016 to April 2017 were enrolled in this study. According to the random number table method, the patients were divided into observation group（n = 60） and control group（n = 59）. On the basis of conventional drug therapy, observation group patients were treated with noninvasive positive pressure ventilation, while control group patients were treated with low flow oxygen inhalation. The sleep quality, hemoglobin, erythrocyte, erythropoietin, pro-BNP level and blood pressure were compared between the two groups. Result After treatment, the levels of hemoglobin, red blood cell, erythropoietin, blood pressure, probrain natriuretic peptide（pro-BNP）, apnea-hypopnea index in observation group were significantly lower than those before treatment and those in control group（P〈0.05）. The levels of the lowest Sa O2 in nights in the observation group were significantly higher than those before treatment and those in the control group（P〈0.05）. The overall degree of satisfaction of observation group was significantly higher than that of control group（P〈0.05）. Conclusion Noninvasive positive pressure ventilation can help elderly patients with heart failure combined with OSAS improve the blood oxygen saturation and the quality of sleep and reduce the level of pro-BNP.