持续正压通气对阻塞性睡眠呼吸暂停综合征患者左心室肥厚及左心室功能的影响

Effect of continuous positive airway pressure on left ventricular hypertrophy and function in patients with obstructive sleep apnea-hypopnea syndrome

目的研究持续正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAHS)患者左心室肥厚及左心室功能的影响。方法98例初次诊断的OSAHS患者(轻度组28例、中度组34例、重度组36例)行CPAP治疗6个月,治疗前、后行彩色多普勒超声检查,控制体质量因素分析治疗前左心室肥厚及左心室功能的影响因素,比较治疗前、后室间隔厚度(IVST)、左心室后壁厚度(LVPW)、左心室射血分数(LVEF)及二尖瓣血流图二尖瓣舒张早期最大血流速度(E峰)与舒张晚期最大血流速度(A峰)比值(E/A)的变化。结果轻、中、重度组IVST及LVPW逐渐增加,LVEF及E/A逐渐降低,差异有统计学意义(P<0.05);控制体质量因素后,IVST、LVPW及LVEF均与呼吸暂停低通气指数(AHI)相关(P<0.05)。治疗后,OSAHS患者IVST由(11.04±1.24)mm降至(10.24±0.82)mm,LVPW由(10.99±1.22)mm降至(10.29±0.85)mm,差异有统计学意义(P<0.05),其中轻度组变化不明显(P>0.05);LVEF由(56.80±5.30)%增至(59.90±4.50)%,E/A由(1.09±0.15)增至(1.20±0.09),差异有统计学意义(P<0.05)。结论CPAP治疗可改善OSAHS患者的左心室肥厚及左心室功能。

Objective To investigate the effect of continuous positive airway pressure(CPAP)on left ventricular hypertrophy and function in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Ninety-eight newly diagnosed OSAHS patients(28 cases in the mild group,34 cases in the moderate group,36 cases in the severe group)were treated with CPAP,color doppler ultrasound was performed to the patients before and 6 months after the treatment,related factors of left ventricular hypertrophy and left ventricular function before treatment were analyzed with controlling weight,and the changes of interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPW),left ventricular ejection fraction(LVEF)and the ratio of peak early filling velocity(E)to peak late velocity(A)diastolic transmitral flow(E/A)were observed.Results In the mild,moderate and severe group,IVST and LVPW increased gradually,LVEF and E/A decreased gradually,the differences were statistically significant(P<0.05),after controlling of weight,IVST,LVPW and LVEF were concerned with apnea-hypopnea index(AHI,P<0.05).After treatment,IVST decreased from(11.04±1.24)mm to(10.24±0.82)mm,LVPW decreased from(10.99±1.22)mm to(10.29±0.85)mm,the differences were statistically significant(P<0.05),the changes were no significant difference in the mild group(P>0.05).LVEF increased from(56.80±5.30)%to(59.90±4.50)%,E/A increased from(1.09±0.15)to(1.20±0.09),the differences were statistically significant(P<0.05).Conclusion CPAP is helpful to improve left ventricular hypertrophy and function in patients with OSAHS.