无创正压通气对冠心病合并阻塞性睡眠呼吸暂停低通气综合征患者心律失常的影响

The Effect of Non-invasive Positive Pressure Ventilation on Arrhythmia in Patients with Coronary Heart Disease Complicated with Obstructive Sleep Apnea Hypopnea Syndrome

目的:分析无创正压通气(NPPV)治疗冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者心律失常的影响。方法:选取2018年5月至2020年6月山东第一医科大学附属肥城医院收治的冠心病合并OSAHS的患者80例作为研究对象,按照随机数字表法分为观察组和对照组,每组40例。对照组给予常规治疗,观察组给予NPPV治疗。比较2组患者短阵室速、室早数、室性及室上性心律失常的数据、治疗前后的超声心电图各项指标、24 h动态心电监测各项生理指标、2组患者接受治疗前后的呼吸指标改善情况[最低血氧饱和度(SaO2low)、夜间睡眠监测总时间(TSTSaO2)、睡眠过程中每小时人体呼吸暂停+低通气次数指数(AHI)]及不良事件发生率。结果:治疗后,与对照组比较,短阵室速、室早数、室性及室上性心律失常、不良事件发生率更低,2组比较差异有统计学意义(均P<0.05);治疗后,观察组患者超声心电图各项指标改善情况均高于对照组,2组比较差异有统计学意义(均P<0.05);观察组患者24 h动态心电监测改善情况相较对照组有较明显提高,差异有统计学意义(P<0.05);观察组呼吸指标各项数据改善情况与对照组比较有较大提高,2组比较差异有统计学意义(P<0.05)。结论:冠心病合并OSAHS患者接受NPPV治疗的效果显著,在改善患者最终治疗成效的同时可以降低其预后阶段的不良反应,并可减少心血管不良事件和心律失常的发生,可做进一步推广研究。

Objective:Analyse the noninvasive positive pressure ventilation(NPPV)on arrhythmia in patients with coronary heart disease combined with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 80 patients with coronary heart disease complicated with OSAHS admitted to Feicheng Hospital Affiliated to Shandong First Medical University from May 2018 to June 2020 were selected as the research subjects,and were divided into observation group and control group according to the random number table method,with 40 patients in each group.The control group received conventional treatment,and the observation group received NPPV treatment.The data of short burst ventricular tachycardia,ventricular premature count,ventricular and supraventricular arrhythmias,ultrasonic ECG indexes before and after treatment,various physiological indexes of 24-hour ambulatory ECG,respiratory indicators improvement before and after treatment[minimum blood oxygen saturation(SaO2low),total time of sleep monitoring at night(TSTSaO2),human apnea+hypopnea times index(AHI)per hour during sleep]and incidence of adverse events in 2 groups.Results:After treatment,the incidence of short-wave ventricular tachycardia,ventricular premature count,ventricular and supraventricular arrhythmias and adverse events was lower than that of the control group,and the difference between the two groups was statistically significant(Ps<0.05).After treatment,the improvement of ultrasonic ECG indexes in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(Ps<0.05).The improvement of 24 h dynamic ECG in observation group was significantly higher than that in control group,and the difference was statistically significant(P<0.05).The improvement of respiratory indicators in the observation group was significantly higher than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:NPPV treatment in patients with coronary heart disease complicated with OSAHS has a significant effect,which can not only improve the final treatment effect of patients,but also reduce the adverse reactions in the prognostic stage,and reduce the occurrence of cardiovascular adverse events and arrhythmia,which can be further popularized.