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目的观察无创正压通气(NIPPV)对充血性心力衰竭合并中枢性睡眠呼吸暂停患者血浆N端脑钠肽前体(NT-proBNP)水平及心功能的影响。方法充血性心力衰竭合并中枢性睡眠呼吸暂停患者45例(年龄>60岁),行NIPPV治疗15-25d。治疗前后行二维超声心动图检查及睡眠呼吸监测,记录左室射血分数(LVEF)、最低脉搏血氧饱和度(SpO2)、睡眠呼吸暂停低通气指数(AHI);用电化学发光法检测血浆NT-proBNP水平。结果 45例患者经NIPPV治疗后,AHI从(35.7±9.3)次/小时降至(8.6±4.7)次/小时(P<0.01),SpO2从(76.5±6.7)%升至(86.2±4.9)%(P<0.01),LVEF值从(50.4±6.2)%升至(55.8±4.3)%(P<0.05),NT-proBNP水平从(2650.4±1033.2)pg/ml降至(1436.8±387.3)pg/ml(P<0.01)。结论 NIPPV治疗能改善充血性心力衰竭合并中枢性睡眠呼吸暂停患者夜间低氧血症,提高LVEF,降低NT-proBNP水平。
Objective To observe the effect of noninvasive positive pressure ventilation (NIPPV) on plasma N-terminal proBNP (NT-proBNP) level and cardiac function in patients with congestive heart failure and central sleep apnea. Methods Forty-five patients (aged> 60 years) with congestive heart failure and central sleep apnea were treated with NIPPV for 15-25 days. Two-dimensional echocardiography and sleep respiration monitoring were performed before and after treatment. Left ventricular ejection fraction (LVEF), minimum pulse oxygen saturation (SpO2) and sleep apnea hypopnea index (AHI) were recorded. Electrochemiluminescence Plasma NT-proBNP levels. Results AHI decreased from (35.7 ± 9.3) / hour to (8.6 ± 4.7) times / hour (P 0.01) and SpO2 increased from (76.5 ± 6.7)% to (86.2 ± 4.9)% in 45 patients after NIPPV treatment. The level of NT-proBNP decreased from (2650.4 ± 1033.2) pg / ml to (1436.8 ± 387.3)% (P <0.01), LVEF increased from (50.4 ± 6.2)% to (55.8 ± 4.3)% pg / ml (P <0.01). Conclusion NIPPV treatment can improve nocturnal hypoxemia, increase LVEF and decrease NT-proBNP level in patients with congestive heart failure and central sleep apnea.