磷酸肌酸钠配合经鼻持续气道正压通气治疗慢性心衰伴OSA的临床观察.docVIP

磷酸肌酸钠配合经鼻持续气道正压通气治疗慢性心衰伴OSA的临床观察 　　【摘要】 目的：观察磷酸肌酸钠配合经鼻持续气道正压通气（n-CPAP）治疗慢性心衰（CHF）伴阻塞性睡眠呼吸暂停（OSA）的临床疗效。方法：选取2012年5月-2015年5月本院收治的86例慢性心衰伴阻塞性睡眠呼吸暂停患者作为研究对象，按照随机数字表法将其分为观察组与对照组，每组各43例。对照组患者给予常规药物及n-CPAP治疗，观察组患者在对照组基础上加用磷酸肌酸钠治疗。观察比较两组患者的临床疗效和治疗前后心功能指标及呼吸睡眠参数。结果：经治疗后，观察组的治疗总有效率88.4%明显高于对照组的48.8%，比较差异有统计学意义（ 字2=15.6020，P=0.0001）。两组治疗前B型脑钠肽（BNP）、左心室射血分数（LVEF）及多导睡眠图参数，比较差异均无统计学意义（P0.05）。两组治疗后BNP水平均明显低于治疗前，LVEF均明显高于治疗前，多导睡眠图参数均明显优于治疗前，且观察组的BNP水平明显低于对照组，LVEF明显高于对照组，最长呼吸暂停时间?p平均呼吸暂停时间?p呼吸暂停低通气指数指数（AHI）及最低SaO2均明显优于对照组，差异均有统计学意义（P0.05）。结论：磷酸肌酸钠配合经鼻持续气道正压通气治疗慢性心衰伴阻塞性睡眠呼吸暂停疗效明确，不仅能明显改善患者的心功能指标，同时还进一步促进了OSA的呼吸睡眠参数的改善。 　　【关键词】 心力衰竭； 阻塞性睡眠呼吸暂停； 磷酸肌酸钠； 经鼻持续气道正压通气 　　【Abstract】 Objective：To observe the clinical efficacy of Creatine Phosphate Sodium combined with nasal continuous positive airway pressure（n-CPAP） for the treatment of chronic heart failure with obstructive sleep apnea（OSA）.Method：Eighty-six chronic heart failure patients with obstructive sleep apnea admitted to our hospital from May 2012 to May 2015 were selected as research objects，they were divided into the observation group and the control group according to the random number table method，43 cases in each group.The control group was given conventional drugs and nasal continuous positive airway pressure for treatment，the observation group was treated with Creatine Phosphate Sodium on the basis of the control group.The clinical effect，the cardiac function indexes and respiratory sleep parameters before and after treatment between the two groups were observed and compared.Result：After treatment，the total effective rate of the observation group was 88.4%，which was significantly higher than 48.8% of the control group，the difference was statistically significant（ 字2=15.6020，P=0.0001）.There were no statistically significant differences in the B type natriuretic peptide（BNP），left ventricular ejection fraction（LVEF） and polysomnogram parameters between the two groups before treatment（P0.05）.After treatment，the BNP level of