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目的:探讨陈-施呼吸(CSR)对慢性充血性心衰(CHF)患者超敏C-反应蛋白(hs-CRP)、脑钠肽(BNP)水平的影响。方法:将入选的心衰患者进行整夜多导睡眠监测,根据监测结果分为有CSR组和无CSR组。分别对两组的睡眠呼吸相关情况、心脏形态及功能、血液生化指标及BNP、hs-CRP值进行比较,并探讨伴有CSR心衰患者的中枢性睡眠呼吸暂停低通气指数(CAHI)与上述指标的相关性。结果:伴有CSR的CHF患者睡眠呼吸紊乱各指标均高于对照组,夜间最低血氧饱和度(SaO2)更低,SaO2<90%时间百分比更长。存在CSR组BNP高于无CSR组,左室射血分数低于对照组,升主动脉内径和左心房内径均明显高于对照组,两组间hs-CRP没有统计学差异。结论:睡眠呼吸障碍在心衰患者中有很高的发生率,特别是当出现了CSR时,可以加重心衰患者的心功能下降程度、加重心脏结构的改变并引起很多其他血液生化改变,导致心衰患者症状加重,预后更差。
Objective: To investigate the effect of Chen-Shih-Chuan (CSR) on the levels of hs-CRP and BNP in patients with chronic congestive heart failure (CHF). Methods: The selected patients with heart failure for overnight polysomnography monitoring, according to the monitoring results were divided into CSR group and CSR-free group. The sleep apnea, cardiac morphology and function, blood biochemical parameters and BNP, hs-CRP were compared between the two groups, and the relationship between central sleep apnea-hypopnea index (CAHI) Correlation of indicators. Results: The indexes of sleep disordered breathing in CHF patients with CSR were all higher than those in control group. The nighttime lowest oxygen saturation (SaO2) was lower, and the percentage of SaO2 <90% was longer. The presence of BNP in CSR group was higher than that in non-CSR group, and the left ventricular ejection fraction was lower than that in control group. The diameter of aorta and the diameter of left atrium in CSR group were significantly higher than those in control group. There was no significant difference in hs-CRP between the two groups. CONCLUSIONS: Sleep-disordered breathing is associated with a high incidence of heart failure, especially when CSR is present, which can exacerbate the decline in cardiac function in patients with HF, aggravate cardiac structural changes and cause many other changes in blood biochemistry leading to Patients with heart failure worse, the prognosis worse.