无创正压通气治疗肥胖低通气综合征并发心力衰竭的探讨

摘要

目的：探讨肥胖低通气综合征（ obesity hypoventilation syndrome，OHS）并发心力衰竭的有效治疗方法。方法回顾性分析120例OHS合并心力衰竭患者，无创正压通气（ noninvasive positive pressure ventilation，NPPV）组60例采用NPPV加常规抗心力衰竭药物治疗，对照组60例常规抗心力衰竭药物治疗，比较2组治疗前、治疗6个月后相关指标。结果对照组治疗后动脉血气分析、脑利钠肽（ brain natriuretic peptide，BNP）、心脏彩超、多导睡眠监测（polysomnography，PSG）均恶化（P﹤0.05或﹤0.01）。NPPV组治疗后体质量指数（body mass index，BMI）下降，动脉血气分析、BNP、心脏彩超、PSG均明显好转（ P﹤0.01）。治疗后与对照组比较，NPPV组BMI、动脉血气分析、BNP、心脏彩超、PSG均明显好转（ P﹤0.01）。结论 OHS并发心力衰竭常规抗心力衰竭疗效不佳，及早行NPPV治疗预后良好。%Objective To explore effective treatments for patients with obesity hypoventilation syndrome complicated by heart failure. Methods Retrospective analysis was performed on 120 patients with obesity hypoventilation syndrome complicated by heart failure. Noninvasive positive pressure ventilation( NPPV)group(60 cases)was treated with NPPV and medications,and the control group(60 cases)only with medications. The related indicators and curative effects before treatment,6 months after treatment were compared between two groups. Results Arterial blood gas analysis,brain natriuretic peptide( BNP ),echocardiography and polysomnography( PSG ) the control group after treatment all worsened(P﹤0. 05 or ﹤0. 01). Body mass index(BMI)decreased,arterial blood gas analysis,BNP, echocardiography and PSG of NPPV group after treatment all improved significantly( P ﹤ 0 . 01 ). Compared with control group after treatment,NPPV group improved significantly in BMI,arterial blood gas analysis,BNP,echocardiography and PSG( P ﹤0. 01 ). Conclusion NPPV is an effective method for patients with obesity hypoventilation syndrome complicated by heart failure.