无创正压通气对心律失常合并睡眠呼吸暂停综合征患者的影响
[Effects of noninvasive positive pressure ventilation on patients with arrhythmia complicated by sleep apnea syndrome].
作者信息
Zhang Peng, Ouyang Song-yun, Sun Pei-zong, Chen Rui-ying, Dai Li-ping, Li Ling, Huang Zhen-wen, Zhang Fei-fei
机构信息
Division of Respiratory Sleep, First Affiliated Hospital,Zhengzhou University,Zhengzhou 450000, China.
Email:
出版信息
Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Sep;41(9):747-50.
OBJECTIVE
To investigate the clinical efficacy of noninvasive positive pressure ventilation (NPPV) in treatment of patients with arrhythmia complicated by sleep apnea syndrome (SAS).
METHODS
One hundred and thirty-five arrhythmia patients with polysomnography diagnosed SAS were randomly divided into NPPV group (69 cases) and control group (66 cases), the NPPV group was treated with standard medications and NPPV, and the control group was treated with standard medications. SAS related parameters were compared between the groups after 3 months therapy.
RESULTS
(1) Epworth sleepiness scale (ESS) score, apnea-hypopnea index (AHI) and arousal index were significantly lower (8.25 ± 5.41 vs.4.08 ± 3.43, 39.95 ± 7.32 vs. 4.71 ± 1.80 and 39.69 ± 4.40 vs. 15.20 ± 2.05, P < 0.01) while not rapid eye movement (NREM) III and rapid eye movement stage of sleep time and lowest pulse oxygen saturation (LSaO2) were significantly higher in NPPV group than in control group [(4.53 ± 2.10)% vs. (16.78 ± 2.59)%,(8.37 ± 1.380)% vs. (15.25 ± 1.41)%, (77.15 ± 6.72)% vs. (93.35 ± 2.03)%, P < 0.01] after 3 months therapy. (2) Incidence of Sinus bradycardia, sinus tachycardia, sinus arrest, atrial premature beats, ventricular premature beats, paroxysmal atrial tachycardia, paroxysmal ventricular tachycardia, atrial fibrillation, II-III degree atrioventricular block, ST-T segment changes were reduced from 57.4%, 44.4%, 7.4%, 20.4%, 13.0%, 36.5%, 12.0%, 8.3%, 37.0%, 53.7% to 4.6%, 1.9%,0.0%, 3.7%, 2.8%, 7.0%, 0.9%, 0.0%, 1.9%, 4.6% (all P < 0.05) and the total number of arrhythmias happened at night were significantly lower (all P < 0.05) while the heart rate variability (HRV) were significantly higher (P < 0.01) in NPPV group than in control group; AHI was positively while LSaO2 was negatively correlated with the total night arrhythmia number (P < 0.01).
CONCLUSION
Noninvasive positive pressure ventilation is an effective therapy strategy for treating patients with arrhythmia complicated by sleep apnea syndrome.
目的
探讨无创正压通气（NPPV）治疗心律失常合并睡眠呼吸暂停综合征（SAS）患者的临床疗效。
方法
将135例经多导睡眠图诊断为SAS的心律失常患者随机分为NPPV组（69例）和对照组（66例），NPPV组采用标准药物联合NPPV治疗，对照组采用标准药物治疗。治疗3个月后比较两组SAS相关参数。
结果
（1）治疗3个月后，NPPV组的爱泼沃斯思睡量表（ESS）评分、呼吸暂停低通气指数（AHI）和觉醒指数显著降低（8.25±5.41 vs.4.08±3.43、39.95±7.32 vs. 4.71±1.80、39.69±4.40 vs. 15.20±2.05，P<0.01），而非快速眼动（NREM）III期和快速眼动睡眠期时间以及最低脉搏血氧饱和度（LSaO2）显著高于对照组[（4.53±2.10）% vs.（16.78±2.59）%、（8.37±1.380）% vs.（15.25±1.41）%、（77.15±6.72）% vs.（93.35±2.03）%，P<0.01]。（2）NPPV组窦性心动过缓、窦性心动过速、窦性停搏、房性早搏、室性早搏、阵发性房性心动过速、阵发性室性心动过速、心房颤动、II-III度房室传导阻滞、ST-T段改变的发生率从57.4%、44.4%、7.4%、20.4%、13.0%、36.5%、12.0%、8.3%、37.0%、53.7%降至4.6%、1.9%、0.0%、3.7%、2.8%、7.0%、0.9%、0.0%、1.9%、4.6%（均P<0.05），夜间发生的心律失常总数显著降低（均P<0.05），而心率变异性（HRV）显著高于对照组（P<0.01）；AHI与夜间心律失常总数呈正相关，LSaO2与夜间心律失常总数呈负相关（P<0.01）。
结论
无创正压通气是治疗心律失常合并睡眠呼吸暂停综合征患者的有效治疗策略。
Zotero 插件