BiPAP呼吸机对慢性心力衰竭合并睡眠呼吸暂停综合征患者血液流变学及血氧水平影响

Effect of BiPAP ventilator on hemorheology and blood oxygenation level in patients with chronic heart failure and sleep apnea syndrome

目的睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)是诱发心血管疾病的重要因素,易加重慢性心力衰竭(chronic heart failure,CHF)患者病情,甚至造成死亡。本研究探讨双水平无创正压通气(bi-level positive airway pressure,BiPAP)呼吸机对CHF合并SAS患者血液流变学及血氧水平的影响。方法选择2018-01-01-2019-01-31巩义市人民医院收治的84例CHF合并SAS患者为研究对象,根据组间性别、年龄和心功能分级具有可比性的原则选择观察组和对照组,各42例。对照组给予常规治疗,观察组在对照组基础上采用BiPAP呼吸机,比较两组血液流变学〔血浆黏度(plasma viscosity,PV)、红细胞比容(hematocrit value,HCT)和红细胞沉降率(erythrocyte sedimentation rate,ESR)〕及血氧水平〔血氧饱和度(oxygen saturation,SaO2)、血氧分压(partial pressure of blood oxygen,PaO2)和动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)〕。结果治疗后,观察组PV、HCT和ESR水平分别为(1.21±0.35)mPa/s、(24.57±2.93)%和(18.74±4.77)mm/h,均低于对照组的(1.79±0.30)mPa/s、(32.43±4.49)%和(22.69±3.62)mm/h,差异有统计学意义,t值分别为8.154、9.501和4.275,均P<0.001;观察组SaO2和PaO2水平分别为(92.12±5.94)%和(80.17±15.26)mm Hg,均高于对照组的(88.05±5.18)%和(62.09±10.24)mm Hg,差异有统计学意义,t值分别为3.347和6.376,均P<0.001;观察组PaCO2水平为(51.48±13.24)mm Hg,低于对照组的(60.54±10.03)mm Hg,t=3.535,P<0.001。结论CHF合并SAS患者应用BiPAP呼吸机治疗,可有效改善血液流变学,纠正缺氧状态,利于患者转归。

OBJECTIVE Sleep apnea syndrome(SAS)is an important factor inducing cardiovascular disease,which can aggravate the condition of patients with chronic heart failure(CHF),and even cause death.The purpose of this study was to investigate the effects of bi-level positive airway pressure(BiPAP)ventilator on Hemorheology and blood oxygen levels in patients with CHF and SAS.METHODS The patients with CHF and SAS who treated in Gongyi People’s Hospital from January 1,2018 to January 31,2019 were selected as subjects.They were divided into observation group and control group according to the gender,age and cardiac function grade,with 42 cases in each group.Control group was given routine treatment,and observation group was given BiPAP ventilator based on control group.The hemorheology[plasma viscosity(PV),hematocrit value(HCT)and erythrocyte sedimentation rate(ESR)]and blood oxygenation level[oxygen saturation(SaO2),partial pressure of blood oxygen(PaO2)and arterial partial pressure of carbon dioxide(PaCO2)]were compared between two groups.RESULTS After treatment,the levels of PV,HCT and ESR in the observation group were(1.21±0.35)mPa/s,(24.57±2.93)%and(18.74±4.77)mm/h,respectively,lower than those in the control group(1.79±0.30)mPa/s,(32.43±4.49)%and(22.69±3.62)mm/h,the difference was significant,t values were 8.154,9.501 and 4.275,respectively,all P<0.001.The levels of SaO2 and PaO2 in the observation group were(92.12±5.94)%and(80.17±15.26)mm Hg,respectively,higher than those in the control group(88.05±5.18)%and(62.09±10.24)mm Hg,the difference was significant,t values were 3.347 and 6.376,respectively,both P<0.001.The PaCO2 level in the observation group was(51.48±13.24)mm Hg,lower than that in the control group(60.54±10.03)mm Hg,t=3.535,P<0.001.CONCLUSION BiPAP ventilator in treatment of patients with CHF and SAS can improve hemorheology,correct the anaerobic condition,and promote the outcome of patients.