摘要
目的探讨无创正压通气(CPAP)对急性失代偿性心力衰竭(ADHF)合并中枢性呼吸睡眠暂停(CSA)患者夜间住院期间不良事件的影响。方法回顾性队列研究2014年1月—2016年12月在温州医科大学附属台州医院诊治的ADHF合并CSA的78例患者临床资料,根据是否使用CPAP将患者分为CPAP组48例和非CPAP组30例。主要观察指标为住院期间夜间不良事件,包括急性心力衰竭(以下简称心衰)发作、心律失常(包括窦性心动过缓、房-室传导阻滞)及猝死。结果两组患者入院时的年龄、性别、体重指数、既往病史中高血压、高脂血症及陈旧心梗病史等临床资料比较,差异无统计学意义(P <0.05);CPAP组氨基末端脑钠肽前体较非CPAP组高(P <0.05)。两组患者夜间急性心衰发作比较,差异有统计学意义(P <0.05);而两组夜间心率失常和猝死比较,差异无统计学意义(P>0.05)。结论 CPAP可降低ADHF合并CSA患者住院期间夜间急性心衰发作的概率,但对心率失常和猝死未见效果。
Objective To investigate the effect of continuous positive airway pressure(CPAP)on adverse events during nighttime hospitalization in patients with acute decompensated heart failure(ADHF)and central sleep apnea(CSA).Methods This was a retrospective cohort study.The clinical data of ADHF patients with CSA treated in Taizhou Hospital of Zhejiang Province from January 2014 to December 2016 were selected and divided into two groups according to whether CPAP was used.The main outcome measures were nocturnal adverse events during hospitalization,defined as acute heart failure,arrhythmia(including sinus bradycardia,atrioventricular block),sudden death.Results There was no significant difference in age,sex,BMI,hypertension,hyperlipidemia and previous MI history between the two groups at admission(P<0.05).The NT-pro BNP in group CPAP was higher than that in non-CPAP group(P<0.05).The primary endpoint of nocturnal adverse events was lower in CPAP group(P<0.05),which was mainly contributed by acute heart failure during night(P<0.05).There was no significant difference in arrhythmia and sudden death rate between the two groups at night(P>0.05).Conclusions CPAP can reduce the incidence of nighttime acute heart failure in ADHF patients with CSA,but has no obvious effect on arrhythmia and sudden death.
作者
王琨
米亚非
葛卫力
李涛
Kun Wang;Ya-fei Mi;Wei-li Ge;Tao Li(Department of Cardiology,Wenling Oriental Hospital,Taizhou,Zhejiang 317525,China;Department of Cardiology,Taizhou Hospital of Zhejiang Province,Taizhou,Zhejiang 318050,China)
出处
《中国现代医学杂志》
CAS
2019年第8期82-85,共4页
China Journal of Modern Medicine
关键词
心力衰竭
呼吸睡眠暂停
中枢性
连续气道正压通气
猝死
心脏
heart failure
sleep apnea,central
continuous positive airway pressure
death,sudden,cardiac
