CAJ | 학술논문

目的观察持续气道正压通气(continuous positive airway pressure,CPAP)治疗前后阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者肺动脉压力和右室前壁厚度的变化.方法确诊为OSAHS的患者,根据心脏彩超检查结果,分为轻度肺动脉高压组、中重度肺动脉高压组和肺源性心脏病组.观察经CPAP治疗前,治疗1个月、3个月肺动脉收缩压和右室前壁厚度的变化.结果 ①肺动脉高压患者治疗1个月和治疗前相比,肺动脉收缩压差异无统计学意义(P＞0.05)；呼吸暂停低通气指数(apnea-hypopnea index,AHI)及平均经皮血氧饱和度(percutaneous oxygen saturation,SpQ2)差异有统计学意义(P＜0.05)；治疗3个月和治疗前相比,肺动脉收缩压、AHI及平均SpO2差异有统计学意义(P＜0.05).②肺源性心脏病患者治疗1个月和治疗前相比,肺动脉收缩压、右室前壁厚度差异无统计学意义(P＞0.05)；治疗3个月和治疗前相比,肺动脉收缩压、右室前壁厚度差异有统计学意义(P＜0.05).结论对于合并肺动脉高压和(或)肺源性心脏病的OSAHS患者,CPAP是降低其肺动脉压力、改善右心结构的有效手段.
목적 관찰지속기도정압통기(continuous positive airway pressure,CPAP)치료전후조새성수면호흡잠정저통기종합정(obstructive sleep apnea-hypopnea syndrome,OSAHS)환자폐동맥압력화우실전벽후도적변화.방법 학진위OSAHS적환자,근거심장채초검사결과,분위경도폐동맥고압조、중중도폐동맥고압조화폐원성심장병조.관찰경CPAP치료전,치료1개월、3개월폐동맥수축압화우실전벽후도적변화.결과 ①폐동맥고압환자치료1개월화치료전상비,폐동맥수축압차이무통계학의의(P＞0.05)；호흡잠정저통기지수(apnea-hypopnea index,AHI)급평균경피혈양포화도(percutaneous oxygen saturation,SpQ2)차이유통계학의의(P＜0.05)；치료3개월화치료전상비,폐동맥수축압、AHI급평균SpO2차이유통계학의의(P＜0.05).②폐원성심장병환자치료1개월화치료전상비,폐동맥수축압、우실전벽후도차이무통계학의의(P＞0.05)；치료3개월화치료전상비,폐동맥수축압、우실전벽후도차이유통계학의의(P＜0.05).결론 대우합병폐동맥고압화(혹)폐원성심장병적OSAHS환자,CPAP시강저기폐동맥압력、개선우심결구적유효수단.
Objective To observe the changes of right ventricular anterior wall thickness and pulmonary artery pressure before and after CPAP treatment in patients with OSAHS.Methods According to echocardiography findings,patients were divided into mild,moderate-severe pulmonary hypertension group and cor pulmonale group,observe the changes of right ventricular anterior wall thickness and pulmonary artery pressure in patients with OSAHS after CPAP treatment 1 month and 3 months.Results ①Apnea hyponea index and average SpO2 have changed after 1 month and 3 months in the patients with pulmonary hypertension ( P ＜ 0.05),but pulmonary artery systolic pressure have changed after 3 months in the patients with pulmonary hypertension ( P ＞ 0.05).② Pulmonary artery systolic pressure and right ventricular anterior wall thickness have no significant imProved after CPAP treatment 1 month in patients with cor pulmonale ( P ＞0.05),but have significant improved after CPAP treatment 3 months ( P ＜0.05).Conclusions CPAP is an effective treatment in patients with OSAHS,that can reduced pulmonary artery systolic pressure and improved right heart structure.