持续正压通气治疗阻塞性睡眠呼吸暂停综合征并发心房纤颤临床观察

目的探讨持续正压通气(CPAP)对阻塞性睡眠呼吸暂停综合征(OSAHS)并发心房纤颤患者的治疗效果。方法选择OSAHS并发心房纤颤患者48例作为观察对象。将其随机分为观察组和对照组各24例。对照组患者给予吸氧,洋地黄制剂、胺碘酮、稳心颗粒、美托洛尔、低分子量肝素钙、华法林等常规治疗,观察组患者在同对照组治疗的基础上给予CPAP治疗,两组疗程均为12个月。观察两组患者治疗前后的临床表现、心房纤颤复发次数、心力衰竭指数的变化及血氧饱和度(SPO2)采用动态心电图和睡眠监测仪检测两组患者治疗前后心率变异数、心房纤颤复发情况并进行心脏功能评价(超声心动图、B型钠脲肽)。结果治疗后观察组患者心率、SPO2、B型钠脲肽、LVEF均优于对照组,差异有统计学意义(P0.01)。治疗后观察组患者房颤转复率显著高于对照组患者,差异有统计学意义(P0.01)。结论 CPAP能有效改善OSAHS并发心房纤颤患者缺氧状态,预防栓塞;有利于患者心房纤颤转复为窦性心律、降低心房纤颤复发率,同时有利于纠正心力衰竭。

Clinical research of continuous positive airway pressure on atrial fibrillation induced by obstructive sleep apnea-hypopnea syndrome

Objective To investigate the therapeutic efficacy of continuous positive airway pressure（ CPAP） on atrial fibrillation induced by obstructive sleep apnea-hypopnea syndrome（ OSAHS）. Methods 48 patients with atrial fibrillation induced by OSAHS were randomly divided into observation group（ n = 24） and control group（ n = 24）. The control group was given conventional treatment as oxygen,digitalis,amiodarone,Wenxin granule,metoprolol,low molecular weight heparin calcium,warfarin,and the observation group was treated with CPAP on the base of control group,the course of treatment of two groups was12 months. The clinical feature,atrial fibrillation recurrence,heart failure index,SPO2 of the two groups were recorded before and after the treatment. Heart rate variability and atrial fibrillation recurrence were tested by dynamic ECG and polysomnography respectively,and the cardiac function（ echocardiography,BNP） was evaluated. Results After treatment,heart rate,SPO2,BNP,LVEF in the observation group were superior to the control group（ P 〈 0. 01）. The cardioversion rate of observation group was significantly higher than that of control group（ P 〈 0. 01）. Conclusions CPAP can improve the oxygen supply of atrial fibrillation induced by OSAHS and prevent thrombosis,favor atrial fibrillation to sinus rhythm,low atrial fibrillation recurrence and control heart failure.