摘要
目的探讨双水平通气对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者合并心功能不全患者的影响及更适宜合并有心功能不全的OSAHS患者的治疗方法。方法将合并有心功能不全的OSAHS患者24例随机分为持续气道正压通气(CPAP)治疗组和双水平气道正压通气(BiPAP)治疗组,治疗3个月后观察左室射血分数(LVEF)、6 min步行试验、Epworth嗜睡量表(ESS)和明尼苏达州的生活与心力衰竭问卷(MLWHF)等方面的变化。结果 LVEF的改善情况:BiPAP组比CPAP组高7.9%(95%置信区间(CI):2.3%至13.4%,P=0.01)。CPAP组改善0.5%(95%置信区间(CI):-2.7%至3.7%;P=0.7)。BiPAP组改善8.5%(95%CI:3.7%至13.4%,P=0.002);在调整OSAHS严重程度、体重指数后,LVEF的改善情况两组之间的差异仍然显著。6 min步行试验ESS、MLWHF等指标改善状况BiPAP组与CPAP组大致相同。结论 BiPAP治疗心力衰竭合并OSAHS患者的左心功能改善情况优于CPAP治疗。
Objective To explore more suitable treatment for patients with heart failure and obstructive sleep apnea hyperpnoea syndrome （OSAHS） by observing the effects of bi-level positive airway pressure （BiPAP） on the left ventricular function of the patients. Methods 24 OSAHS patients with combined determination dysfunction were randomly divided into continuous positive airway pressure （CPAP） treatment group and BiPAP treatment group. After three-month treatment, their changes in the left ventrieular ejection fraction（LVEF） , the 6-minutes walk test, Epworth sleepiness scale and Minnesota living with heart failure questionnaire were observed. Results The LVEF of the BiPAP group were 7.9% （95% CI： 2.3%-13.4% , P =0. 01 ） higher than that of the CPAP group, with the CPAP group improved by 0.5% （95% CI： -2.7% - 3.7% ; P =0.7） and the BiPAP group improved by 8.5% （95% CI： 3.7%-13.4% , P =0. 002）. After adjusting the severity of OSAHS and BMI, there was still significant difference between the improvement of LVEF. Conclusions BiPAP works better in improving the left ventricular function of patients with heart failure and obstructive sleep apnea than CPAP.
出处
《中华肺部疾病杂志（电子版）》
CAS
2014年第3期57-61,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
双水平气道正压通气
持续气道正压通气
左室射血分数
低通气综合征
睡眠呼吸暂停
阻塞性
Bi-level positive airway pressure
Continuous positive airway pressure
Left ventricular ejection fraction
Obstructive sleep apnea hyperpnaes syndrome
