胡恺 庄曼茹 吴平彬

[摘要]目的 观察鼻持续气道内正压通气（nCAPA）治疗阻塞性睡眠呼吸暂停综合征（OSAS）合并心律失常患者的效果。方法 选取2015年2月～2017年8月我院收治的70例OSAS合并心律失常患者作为研究对象，随机分为两组，每组各35例。对照组患者仅采用口服抗心律失常药物进行治疗，观察组患者在口服抗心律失常药物治疗基础上加用nCAPA治疗，两组患者治疗时间均为3个月。比较两组患者的治疗总有效率，采用Polysmith监测系统检测两组患者治疗前及治疗后夜间睡眠时最快心率（HR）、夜间睡眠时最慢HR、最低血氧饱和度（SaO2low）、SaO2<90%占夜间睡眠监测总时间的百分比（TSTSaO2<90%）等相关指标，采用GWE-10动态心电图记录仪检测两组患者夜间睡眠期间各种类型心律失常的发生次数。结果 观察组患者的治疗总有效率（91.43%）高于对照组（71.43%），差异有统计学意义（P<0.05）；观察组治疗后夜间睡眠时最慢HR、SaO2low高于治疗前和对照组治疗后 （P<0.05），观察组治疗后夜间睡眠时最快HR、AHI、TSTSaO2<90%及夜间心律失常发生次数低于治疗前和对照组治疗后（P<0.05）。结论 nCAPA治疗OSAS合并心律失常患者的效果显著，可明显减少心律失常的发生，改善OSAS症状。

[关键词]经鼻持续气道内正压通气；阻塞型睡眠呼吸暂停综合征；心律失常

[中图分类号] R766 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0069-03

[Abstract] Objective To observe the curative effect of nCAPA in the treatment of patients with OSAS combined with arrhythmia. Methods A total of 70 patients with OSAS combined with arrhythmia treated in our hospital from February 2015 to August 2017 were randomly divided into two groups， with 35 cases in each group. The control group was only treated with antiarrhythmic drugs by oral， and the observation group was treated with nCAPA on the basis of the antiarrhythmic drugs by oral， the treatment time of two groups was all 3 months. The total effective rates of two groups were compared. The related indicators such as the fastest HR at night， the slowest HR at night， SaO2low， TSTSaO2<90% in both groups before and after treatment were detected by polysmith monitoring system. The occurrence of various types of arrhythmias during night sleep of two groups were detected by GWE-10 dynamic electrocardiograph. Results The total effective rate of the observation group （91.43%） was higher than that of the control group （71.43%）， the difference was sitatistically significiant （P<0.05）. The slowest HR at night， SaO2low of the observation group after treatment were higher than those of before treatment and the control group after treatment （P<0.05）. The fastest HR at night， AHI， TSTSaO2<90% and occurrence of various types of arrhythmias during night sleep were lower than those of before treatment and the control group after treatment （P<0.05）. Conclusion The nCAPA intervention is effective in the treatment of OSAS patients with arrhythmia. It can significantly reduce the arrhythmia and improve the symptoms of OSAS.

[Key words] Nasal continuous positive airway pressure ventilation； Obstructive sleep apnea syndrome； Arrhythmia

阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）不但是誘导各种心脑血管疾病发生的危险性因素，也是导致夜间发生猝死的重要原因之一[1]。目前临床针对OSAS合并心律失常患者主要采用药物治疗，但难以获得理想的治疗效果[2-3]。有研究显示[4-5]，经鼻持续气道内正压通气（nasal-continuous positive airway pressure，nCAPA）可明显缓解OSAS患者的临床症状，降低各类型心律失常的发生率。本研究旨在探讨nCAPA干预治疗对OSAS合并心律失常患者的影响，现报道如下。

1资料与方法

1.1 一般资料

选取本院心血管内科2015年2月～2017年8月住院治疗的70例OSAS合并心律失常患者作为研究对象，患者均符合OSAS及心律失常相关诊断[6-7]。将患者根据简单随机分组法分为观察组和对照组，每组各35例。对照组男28例，女7例；年龄52～65岁，平均（58.4±6.1）岁；体质指数（Body Mass Index，BMI）为（22.6±2.4）kg/m2；OSAS严重程度为轻度7例，中度15例，重度13例。……