CPAP对OSA合并特发性室性心律失常的作用

Efficacy of Continuous Positive Airway Pressure Ventilation on Obstructive Sleep Apnea with Idiopathic Ventricular Arrhythmia

目的:分析阻塞性睡眠呼吸暂停(OSA)合并特发性室性心律失常(IVA)患者睡眠呼吸参数与IVA的相关性,并探讨持续正压通气(CPAP)对该类患者的疗效。方法:纳入2015年4月~2019年8月于我院诊断为OSA合并IVA的患者85例,所有患者就诊第1天及CPAP治疗12周后,均行多导睡眠图(PSG)和24 h动态心电图监测。分析患者呼吸睡眠参数(AHI指数、最低SpO 2、SpO 2<90%百分比)与IVA的关系。结果:OSA合并IVA患者中,室性心律失常与AHI、SpO 2<90%百分比、体质量及BMI均呈正相关(均P<0.01),与最低SpO 2呈负相关(P<0.01)。患者经CPAP治疗12周后,呼吸睡眠参数均明显改善(均P<0.05),室性心律失常次数(PVC、NSVT)均显著减少(均P<0.05)。结论:OSA合并IVA患者睡眠呼吸参数与IVA具有相关性,CPAP能显著改善患者睡眠呼吸参数,并减少IVA的发生。

Objective:To analyze the correlation between sleep breathing parameters and idiopathic ventricular arrhythmia(IVA)in patients with obstructive sleep apnea(OSA)combined with IVA,and to explore the efficacy of continuous positive pressure ventilation(CPAP)in the treatment of these patients.Methods:A total of 85 patients diagnosed as OSA complicated with IVA in our hospital from April 2015 to August 2019 were enrolled.All patients received polysomnogram(PSG)monitoring and 24 h dynamic electrocardiogram monitoring on the first day of treatment and 12 weeks after CPAP treatment.The relationship between respiratory sleep parameters(including AHI index,minimum SpO 2,percentage of SpO 2<90%)and IVA were analyzed.Results:Ventricular arrhythmia was positively correlated with AHI,percentage of SpO 2<90%,body weight and BMI(all P<0.01),while negatively correlated with the minimum SpO 2(P<0.01)in OSA combined with IVA.After the treatment of CPVP for 12 weeks,the respiratory sleep parameters were significantly improved(all P<0.05),and ventricular arrhythmia(PVC,NSVT)were reduced significantly(all P<0.05).Conclusion:For OSA combined with IVA,sleep respiratory parameters are correlated with IVA,and CPAP can significantly improve the sleep respiratory parameters and reduce the occurrence of IVA.