【摘要】 目的合并阻塞型呼吸暂停的老年慢性收缩性心力衰竭患者,在常规药物治疗基础上,观察持续正压气道通气方法的临床疗效。方法门诊或住院的老年慢性收缩性心力衰竭患者,夜间多导睡眠诊断合并阻塞型呼吸暂停的患者61例,按照随机方法分为研究组(29例)和对照组(32例),药物治疗病情平稳2周后,研究组加用持续正压气道通气治疗,对照组继续药物治疗,8周后比较两组临床表现、超声心动图指标和血清B型钠尿肽的变化情况。结果与对照组相比,研究组8周治疗后6min步行试验增加(103±93)m(P<0.01),心率平均下降(7±2)次/min(P<0.01)、收缩压平均下降(10±3)mmHg(P<0.05),舒张压变化不明显;左室射血分数明显提高5%(P<0.05),左室收缩末径下降2mm(P<0.05),每搏输出量增加4ml/次(P<0.01),血清B型钠尿肽下降651ng/L(P<0.01)。结论对于合并阻塞型呼吸暂停的老年慢性收缩性心力衰竭患者,常规药物治疗基础上加用持续正压气道通气方法,有利于改善患者的心功能,改善心肌重塑。更多还原

【Abstract】 Objective To investigate the clinical efficacy of continuous positive air pressure ventilation in treatment of chronic systolic heart failure (CSHF) in elderly patients with obstructive sleep apnea (OSA). Methods Sixty-one CSHF elderly patients were diagnosed to have OSA by polysomnography. They were randomly divided into two groups:experimental group (29 patients) and control group (32 patients). After the patients’ condition became stable by treatment with medications (β-blockers and ACEI agents) for 2 weeks,the experimental group was treated with a combination of drugs and nasal positive pressure ventilation,and the control group was still treated only with medications. After 8 weeks,clinical symptoms,echocardiographic indexes and BNP were compared between the two groups. Results Compared with the control group,6 min walking test increased by (103±93) m (P<0.01),heart rate decreased by (7±2) beats/min (P <0.05),systolic blood pressure decreased by (10±3)mmHg (P<0.05),stroke volume and left ventricular ejection fraction increased by 4ml(P<0.01)and 5% (P<0.05),respectively; left ventricular end-systolic diameter was reduced by 2mm (P<0.05) and brain natriuretic peptide decreased by 651ng/L (P<0.01) in the experimental group. There was no statistically significant difference in left ventricular end-diastolic diameter between the two groups. Conclusion Nasal positive pressure ventilation is an effective method for treating CSHF in elderly patients with OSA.更多还原