持续气道正压通气在阻塞性睡眠呼吸暂停低通气综合征合并冠心病治疗中的作用观察

摘 要 目的：研究持续气道正压通气（CPAP）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并冠心病（CHD）治疗中的应用价值。方法: OSAHS合并CHD患者50例随机分为对照组和CPAP组两组，每组25例。对照组患者给予常规药物治疗，CPAP组患者在对照组基础上加以CPAP治疗。6个月后比较两组患者的多导睡眠仪（PSG）指标、临床症状、心律失常、心电图心肌缺血改变。结果: CPAP组患者治疗6个月后AHI、氧减指数较治疗前明显降低，SaO₂最低值、SaO₂平均值则较前明显升高（P<0.01），且均优于对照组（P<0.01）。两组患者胸痛胸闷、心律失常发生率、1 d内心肌缺血发生次数、1d内心肌缺血时间等均较前下降（P<0.01），且CPAP组明显优于对照组（P<0.01）。结论:CPAP联合CHD常规治疗能提高OSAHS合并CHD患者的血氧浓度，降低心律失常和心肌缺血的发生率，可广泛应用于临床。

Effect of Continuous Positive Airway Pressure in the Treatment of Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Coronary Heart Disease

ABSTRACT Objective: To explore the application value of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS ) complicated with coronary heart disease (CHD). Methods:Totally 50 patients with OSAHS complicated with CHD from June 2012 to June 2014 in our hospital were randomly divided into the control group and CPAP group with 25 ones in each. The patients in the control group were treated with the conventional drug therapy for coronary heart disease, while those in CPAP group were treated with CPAP additionally. After 6 month treatment, PSG index, clinical symptoms, arrhythmia and ischemia electrocardiogram changes of the patients in the two groups were compared. Results:After the 6 month treatment, AHI and oxygen desaturation index in CPAP group were significantly decreased when compared with those before the treatment, and the minimum value of SaO₂ and the average value of SaO₂ were higher than those before the treatment (P<0.01), and the above indices were better than those in the control group (P<0.01). The incidence rate of chest pain and chest tightness, arrhythmia, times of myocardial ischemia in a day and time of myocardial ischemia in a day were decreased after the treatment (P<0.01), and the decrease in CPAP group was more notable than that in the control group (P<0.01). Conclusion:CPAP combined with the conventional drug therapy for coronary heart disease can improve the oxygen concentration and reduce the incidence of arrhythmia and myocardial ischemia in the patients with OSAHS with CHD, which can be widely used in clinics.