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目的探讨无创正压通气(NPPV)对慢性阻塞性肺疾病(COPD)并夜间低氧血症(NOD)患者心率变异性(HRV)的影响。方法选取2012年9月—2015年6月深圳市第二人民医院收治的COPD患者50例,根据多导睡眠图监测结果分为NOD组24例和非NOD组26例,NOD组患者在临睡前给予双水平气道正压通气(Bi PAP)辅助通气。比较两组患者临床资料、第1个晚上及第2个晚上HRV相关指标。结果两组患者第一秒用力呼气容积与用力肺活量比值(FEV1/FVC)比较,差异无统计学意义(P>0.05);NOD组患者年龄大于非NOD组,动脉血二氧化碳分压(Pa CO2)高于非NOD组,用力肺活量占预计值百分比(FVC%)、第一秒用力呼气容积占预计值百分比(FEV1%)及动脉血氧分压(Pa O2)低于非NOD组(P<0.05)。第一个晚上,NOD组患者极低频(VLF)、低频(LF)及高频(HF)均低于非NOD组(P<0.05);第二个晚上,两组患者VLF、LF及HF比较,差异无统计学意义(P>0.05)。结论 NPPV可有效改善COPD并NOD患者HRV,从而降低患者心血管疾病发生风险。
Objective To investigate the effect of noninvasive positive pressure ventilation (NPPV) on heart rate variability (HRV) in patients with chronic obstructive pulmonary disease (COPD) and nocturnal hypoxemia (NOD). Methods Fifty patients with COPD admitted to Shenzhen Second People’s Hospital from September 2012 to June 2015 were divided into 24 patients in NOD group and 26 patients in non-NOD group according to the results of polysomnography. Prior to the bi-level positive airway pressure (Bi PAP) assisted ventilation. The clinical data of two groups were compared, HRV-related indicators on the first night and the second night. Results There was no significant difference between the first second forced expiratory volume and forced vital capacity (FEV1 / FVC) in both groups (P> 0.05). The NOD group was older than non-NOD group and the arterial carbon dioxide partial pressure ) Was higher than that of non-NOD group (FVC%), forced expiratory volume in the first second (FEV1%) and arterial oxygen pressure (Pa O2) were lower than those in the non-NOD group <0.05). On the first night, VLF, LF and HF in NOD group were significantly lower than those in non-NOD group (P <0.05). On the second night, VLF, LF and HF were compared between the two groups , The difference was not statistically significant (P> 0.05). Conclusion NPPV can effectively improve the COPD and NOD patients with HRV, thereby reducing the risk of cardiovascular disease.