持续气道正压通气治疗冠心病合并 OSA HS 疗效观察

[目的]观察持续气道正压通气（CPAP）治疗对冠心病合并阻塞性睡眠呼吸暂停通气综合征（OS-AHS）的临床疗效。[方法]选取经冠状动脉造影及睡眠呼吸监测确诊为冠心病合并中重度OSAHS患者共40例，随机分为两组各20例，对照组给予冠心病常规药物治疗，试验组给予常规药物＋CPAP治疗，半年后观察各组心脏临床症状及睡眠呼吸监测指标。[结果]试验组在常规药物＋CPAP治疗半年后，患者夜间发生胸痛、胸闷气短症状，心律失常及心电图心肌缺血改变明显减少，睡眠呼吸暂停低通气指数（AHI）、夜间最低血氧饱和度（SaO2）及平均SaO2改善优于对照组（ P ＜0．05）。[结论]CPAP治疗可改善冠心病合并OSAHS患者的低氧血症，使其心肌缺血、心律失常发生率降低，临床应对冠心病并发中重度OSA HS患者在药物治疗基础上给予CPAP治疗。

Clinical Application of Continuous Positive Airway Pressure for the Treatment of Patients with Coronary Heart Disease and OSAHS

[Objective] To observe the clinical efficacy of continuous positive airway pressure （CPAP） for the treatment of patients with coronary heart disease （CHD） and obstructive sleep apnea hypopnea syndrome （OSAHS） .[Methods]A total of 40 patients with CHD and severe OSAHS confirmed by coronary angiography and sleep apnea monitoring merger were chosen and randomly divided into two groups .The control group re-ceived routine medicine treatment of CHD ,while the experimental group received conventional drugs and CPAP therapy .Clinical cardiac symptoms and the monitoring indicators of sleep apnea after 6 months were ob-served .[Results] In the experimental group ,the symptoms such as nocturnal chest pain ,chest tightness , shortness of breath symptoms ,arrhythmias and ECG changes of myocardial ischemia after conventional drugs and CPAP therapy for 6 months were decreased ,and sleep apnea-hypopnea index（AHI） and the improvement oflowestnocturnaloxygensaturation（SaO2）andaverageSaO2werebetterthanthecontrolgroup（P〈0.05）.[Conclusion]CPAP therapy can improve hypoxemia in patients with CHD and OSAHS ,and also may reduce the incidence of myocardial ischemia and arrhythmia .In addition to drug therapy ,CPAP therapy should be given for patients with CHD and severe OSAHS .