持续气道正压通气治疗对OSAHS并发冠心病患者的影响

目的:探讨持续气道正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并发冠心病患者的影响。方法:入选26例中重度OSAHS并发冠心病患者,进行睡眠呼吸监测、脉搏波传导速度(PWV)及动态心电图检查,在冠心病治疗基础上进行CPAP治疗4个月,分别于治疗2个月末及4个月末复查PWV、睡眠呼吸监测及动态心电图检查,比较治疗前后睡眠呼吸监测指标、PWV水平、24 h心肌缺血总时间及24 h心肌缺血发作总次数的变化。结果:患者经CPAP治疗2个月和4个月后24 h心肌缺血总时间及24 h心肌缺血发作总次数均减少,PWV水平下降,并且在治疗4个月较治疗2个月后相关指标又有所下降。结论:CPAP治疗可以纠正OSAHS并发冠心病患者低氧血症,使其心肌缺血改善、PWV水平降低,应对冠心病并发中重度OSAHS患者在药物治疗基础上给予CPAP治疗。

Treatment of continuous positive airway pressure for patients with obstructive sleep apnea-hypopnea syndrome and coronary atherosclerotic heart disease

AIM: To investigate the effect of continuous positive airway pressure (CPAP) treatment on patients with moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS) and coronary atherosclerotic heart disease (CAHD). METHODS: Twenty-six patients with moderate to severe OSAHS and CAHD were enrolled. Sleep respiratory monitoring and dynamic electrocardiogram (ECG) were performed in all patients. Patient group was given CPAP treatment and conventional treatment for 4 months. Sleep respiratory monitoring and dynamic ECG were performed, respectively, at the end of 2 and 4 months, and parameters of the sleep respiratory monitoring, PWV level, total time of myocardial ischemia and total number of myocardial ischemia attacks at 24 h before and after treatment were compared. RESULTS: PWV level, total time of myocardial ischemia and total number of myocardial ischemia attacks in 24 h decreased after 2 or 4 months treatment. The parameters at the end of 4 months treatment were lower than those at the end of 2 months. CONCLUSIONS: CPAP treatment can improve hypoxemia and myocardial ischemia and decrease PWV level and can be applied together with pharmacotherapy to patients with moderate to severe OSAHS and CAHD.