Sasayama Shigetake
Hamamatsu Rosai Hospital.
Nihon Rinsho. 2006 May;64(5):968-73.
Recently, there is increasing evidence that sleep apnea may adversely affect pathophysiology and outcomes of congestive heart failure (CHF). Repetitive nocturnal apneas may worsen CHF through a number of mechanisms including the repetitive arterial oxygen desaturation, increased left ventricular afterload, or an activation of sympathetic nervous system. Although central sleep apnea (CSA) is relatively rare, prospective studies revealed that 33 to 82 % of patients with CHF have evidence of CSA and characteristic Cheyne-Stokes respiration (CSR). We assessed an efficacy of nasal O2 therapy at night using a conventional O2 concentrator in ambulatory patients with stable CHF and CSR. O2 resulted in a significant improvement of sleep together with an increase in left ventricular function and quality of life. Therefore, home oxygen therapy(HOT) can be a valuable nonpharmacological option for the treatment of patients with CHF and CSR-CSA.
最近,越来越多的证据表明,睡眠呼吸暂停可能会对充血性心力衰竭(CHF)的病理生理和预后产生不利影响。夜间反复出现的呼吸暂停可能通过多种机制使CHF恶化,包括反复的动脉血氧饱和度下降、左心室后负荷增加或交感神经系统激活。虽然中枢性睡眠呼吸暂停(CSA)相对少见,但前瞻性研究显示,33%至82%的CHF患者有CSA和典型的潮式呼吸(CSR)证据。我们评估了在门诊稳定CHF和CSR患者中使用传统制氧机进行夜间鼻导管给氧治疗的疗效。吸氧可显著改善睡眠,同时提高左心室功能和生活质量。因此,家庭氧疗(HOT)可能是治疗CHF和CSR-CSA患者的一种有价值的非药物选择。