心力衰竭合并阻塞性睡眠呼吸暂停患者止鼾枕治疗的有效性研究

摘要

目的 探讨止鼾枕对心力衰竭合并不同严重程度阻塞性睡眠呼吸暂停的临床疗效.方法 选择47例睡眠呼吸暂停低通气综合征(OSAHS)患者和12例单纯性鼾症患者作为研究对象,分为3组,分别为对照组(单纯性鼾症组)12例、轻中度OSAHS组26例和重度OSAHS组21例.每组夜间均在睡眠监测同时使用止鼾枕治疗,记录分析治疗前与治疗期间的睡眠参数.结果 重度及轻中度OSAHS组患者止鼾枕矫正期间AHI、RI、OAI、ODI及鼾声指数均显著降低,平均SpO2％明显改善(P＜0.05).而单纯鼾症组,治疗期间除了有效减少打鼾之外,其余睡眠监测参数差异均无统计学意义(P＞0.05).结论 止鼾枕能够显著降低鼾声指数,并且明显改善心力衰竭合并OSAHS患者AHI及缺氧情况,但对于严重OSAHS患者阻塞性睡眠呼吸暂停及夜间低氧血症改善不及轻中度OSAHS患者显著,不能替代传统气道正压通气治疗.%Objective To investigate the effect of anti-snoring pillow for the treatment of obstructive sleep apnea in patients with heart failure.Methods Forty seven HF patients with OSAHS and 12 HF patients with simple snoring were enrolled.All the patients were divided into 3 groups:control group (n =12),mild-moderate OSAHS group (n =26) and severe OSAHS group (n =21).All the patients received the treatment of anti-snoring pillow and their sleep apnea parameters were evaluated by PSG at the same time.Results The sleep apnea parameters including AHI,OAI,ODI,mean SpO2％ and snore index were significantly improved in severe and mild moderate OSAHS group with anti-snoring pillow.Conclusion Anti-snoring pillow can reduce snoring index in all OSAHS patients and simple snorers.Sleep apnea and hypoxemia were greatly improved in mild-moderate OSAHS-HF patient while the anti-snoring pillow is not perfect in severe OSAHS patients with HF to replace PAP.