无创正压通气对心力衰竭合并阻塞性睡眠呼吸暂停综合征患者红细胞生成素及N-末端脑钠肽前体水平的影响

发布时间：2018-09-15 07:05

【摘要】：目的探究无创正压通气(NPPV)对心力衰竭合并阻塞性睡眠呼吸暂停综合征(OSAHS)患者红细胞生成素(EPO)以及N-末端脑钠肽前体(NT-proBNP)水平的影响,为NPPV对心力衰竭合并OSAHS的治疗提供理论依据。方法研究对象为2013年5月—2016年5月期间于荆州市第三人民医院治疗的50例中重度心力衰竭合并OSAHS患者和50例体检正常患者,将50例中重度心力衰竭合并OSAHS患者设为OSAHS组,50例体检正常患者设为对照组。治疗前后检测患者EPO、血红蛋白(Hb)、红细胞计数(RBC)、平均红细胞蛋白含量(MCH)、红细胞比积(HCT)、平均红细胞体积(MCV)、NT-proBNP水平、中心收缩压、中心舒张压、夜间平均最低血氧饱和度(LSaO_2)以及睡眠呼吸暂停低通气指数(AHI)。结果 OSAHS患者治疗前后EPO、Hb、RBC、MCH、HCT、MCV均高于对照组(P0.05);OSAHS患者治疗后EPO、Hb、RBC、MCH、HCT、MCV均低于治疗前(P0.05);OSAHS患者治疗前后NT-proBNP水平、中心收缩压、中心舒张压均高于对照组(P0.05);OSAHS患者治疗后NT-proBNP水平、中心收缩压、中心舒张压均低于治疗前(P0.05);OSAHS患者治疗前后LSaO_2、AHI均低于对照组(P0.05);OSAHS患者治疗后LSaO_2、AHI均高于治疗前(P0.05);NT-proBNP水平、EPO、中心收缩压、中心舒张压与AHI呈正相关(r=0.547、r=0.864、r=0.487、r=0.657,P0.05);NT-proBNP水平、EPO、中心收缩压、中心舒张压与LSaO_2呈负相关(r=-0.574、r=-0.693、r=-0.754、r=-0.583,P0.05)。结论 NPPV能够显著改善心力衰竭合并OSAHS患者NT-proBNP水平及EPO,同时显著改善LSaO_2及AHI,改善睡眠质量,降低器官损害,保证患者良好的预后效果。
[Abstract]:Objective to investigate the effects of noninvasive positive pressure ventilation (NPPV) on the levels of erythropoietin (EPO) and N-terminal brain natriuretic peptide precursor (NT-proBNP) in patients with congestive heart failure complicated with obstructive sleep apnea syndrome (OSAHS). Methods from May 2013 to May 2016, 50 patients with moderate and severe heart failure complicated with OSAHS and 50 normal persons with physical examination were treated in Jingzhou third people's Hospital. 50 patients with moderate or severe heart failure complicated with OSAHS were divided into OSAHS group and 50 normal physical examination patients as control group. EPO, hemoglobin (Hb), RBC count (RBC), mean erythrocyte protein content (MCH), hematocrit (HCT), mean RBC volume (MCV) / NT-proBNP level, central systolic blood pressure, central diastolic blood pressure (CPP), central systolic blood pressure (CPP), central diastolic blood pressure (CPP), Nocturnal mean minimum oxygen saturation (LSaO_2) and sleep apnea hypopnea index (AHI).) Results before and after treatment, EPO,Hb,RBC,MCH,HCT,MCV in OSAHS patients was higher than that in control group (P0.05). The levels of NT-proBNP, central systolic blood pressure and central diastolic blood pressure in patients with OSAHS were lower than those before and after treatment (P0.05), and the levels of NT-proBNP and systolic blood pressure in patients with OSAHS were higher than those in control group (P0.05). Central diastolic blood pressure was lower than that before and after treatment (P0.05) the LSaO_2,AHI of OSAHS patients before and after treatment was lower than that of control group (P0.05). The level of LSaO_2,AHI in OSAHS patients after treatment was higher than that before treatment (P0.05). The central systolic blood pressure and central diastolic blood pressure were positively correlated with AHI (r = 0.547r0.864r0.487r0.487r0.657P). There was a negative correlation between central diastolic blood pressure and LSaO_2 (P 0.05). Conclusion NPPV can significantly improve the level of NT-proBNP and EPO, in patients with heart failure and OSAHS, and improve the quality of sleep, reduce organ damage and ensure a good prognosis of patients with LSaO_2 and AHI,.
【作者单位】：湖北省荆州市第三人民医院;
【分类号】：R541.6;R766

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