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阻塞性睡眠呼吸暂停(OSA)时胸腔内负压的波动同由缺氧和惊醒引起的交感神经系统张力增高一起,可能导致肺水肿和左室肥厚。作者研究原发性扩张型心肌病继发充血性心衰的患者,了解OSA是否损害左室功能,并估价经鼻连续正压给氧(NCPAP)的治疗作用。 8例男性患者(年龄29～69岁),均属肥胖体型。在药物治疗保持不变的条件下,NC-PAP治疗以前和治疗之后4周测量左室射血分数分别为37±4％和49±5%(P<0.001)。4例患者在停用NCPAP后一周左室射血分数从治疗期间的 53±6%降至 45±5%(P<0.001)。治疗之前和治疗期间 OSA发作
Fluctuations in the intrathoracic negative pressure during obstructive sleep apnea (OSA), together with increased sympathetic nervous system tension resulting from hypoxia and arousals, may lead to pulmonary edema and left ventricular hypertrophy. The authors studied patients with congestive heart failure secondary to dilated cardiomyopathy to determine whether OSA compromised left ventricular function and assessed the therapeutic efficacy of nasal continuous positive pressure oxygenation (NCPAP). Eight male patients (aged 29 to 69 years), are obese. Left ventricular ejection fraction was 37 ± 4% and 49 ± 5% (P <0.001) before NC-PAP treatment and 4 weeks after treatment, respectively, with drug treatment unchanged. Four patients had a one-week drop in LVEF from 53 ± 6% during treatment to 45 ± 5% (P <0.001) one week after discontinuation of NCPAP. OSA episodes before and during treatment