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

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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,Sa O2最低值、Sa O2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。 Objective: To investigate the value of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) with coronary heart disease (CHD). Methods: Fifty OSAHS patients with CHD were randomly divided into control group and CPAP group, with 25 cases in each group. Patients in the control group were given conventional medical therapy. Patients in the CPAP group were treated with CPAP on the basis of the control group. Six months later, polysomnography (PSG), clinical symptoms, arrhythmia and electrocardiogram myocardial ischemia were compared between the two groups. Results: After 6 months of treatment, the AHI and oxygen decrement index in CPAP group were significantly lower than those before treatment, and the lowest value of Sa O2 and the average value of Sa O2 were significantly higher than those of the control group (P <0.01) <0.01). Chest pain, chest tightness, incidence of arrhythmia, number of myocardial ischemia within 1 d, myocardial ischemic time within 1 d decreased compared with the previous two groups (P <0.01), and CPAP group was significantly better than the control group (P <0.01) . Conclusion: CPAP combined with conventional CHD can improve the oxygen concentration of OSAHS patients with CHD, and reduce the incidence of arrhythmia and myocardial ischemia, which can be widely used in clinic.
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