ACEI及无创呼吸机辅助治疗心衰合并OSAHS的疗效及对血清BNP水平的影响

目的:探讨血管紧张素转换酶抑制剂(Angiotensin-converting enzyme inhibitor,ACEI)联合无创呼吸机辅助治疗心衰合并阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)疗效及对血清脑钠素(Brain natriuretic peptide,BNP)水平的影响。方法:抽取我院自2013年1月到2019年4月收治的98例心衰合并OSAHS患者,根据治疗方法分为对照组(49例,ACEI常规治疗)与实验组(49例,ACEI联合无创呼吸机辅助治疗),比较两组患者治疗前后红细胞生成素(Erythropoietin,EPO)、血红蛋白(hemoglobin,Hb)、红细胞计数(red blood cell,RBC)、平均红细胞蛋白含量(Mean corpuscular protein content,MCH)、血细胞比容(Hematocrit,HCT)、平均红细胞体积(Mean red blood cell volume,MCV)、夜间平均最低血氧合度(Lowest oxygen saturation,LSaO2)、睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、血清脑钠素(Brain natriuretic peptide,BNP)水平、中心收缩压(systolic pressure,SP)及中心舒张压(diastolic pressure,DP)的变化。结果:治疗后,两组患者EPO、Hb、RBC、MCH、HCT、MCV水平均明显低于治疗前,且实验组患者的以上指标水平均显著低于对照组(P<0.05)。两组治疗后LSaO2高于明显高于治疗前,AHI水平低于治疗前,且实验组LSaO2高于对照组,AHI水平低于对照组(均P<0.05)。治疗后两组患者BNP、SP和DP明显低于治疗前(P<0.05),且实验组患者的以上指标水平低于对照组(P<0.05)。实验组患者的术后并发症发生率明显低于对照组(P<0.05)。结论:ACEI及无创呼吸机辅助治疗心衰合并OSAHS可改善患者的睡眠紊乱、睡眠呼吸障碍、心衰及高血压,具有临床推广应用的价值。

Efficacy of ACEI and Non-invasive Ventilator in the Treatment of Heart Failure Combined with OSAHS and Its Effect on the Serum BNP Levels

ABSTRACT Objective: To investigate the efficacy of angiotensin-converting enzyme inhibitor (ACEI) and non-invasive ventilator in the treatment of heart failure with obstructive sleep apnea hypopnea syndrome (OSAHS) and its effect on BNP. Methods: 98 patients with heart failure and OSAHS from January 2013 to April 2019 were enrolled. According to the treatment, they were divided into control group (49 cases, conventional treatment with ACEI) and experimental group (49 cases, ACEI combined with non-invasive breathing). Machine-assisted treatment), comparing EPO, Hb, RBC, MCH, HCT, MCV, LSaO₂, AHI, serum BNP, SP, DP before and after treatment in the two groups. Results: After treatment, the levels of EPO, Hb, RBC, MCH, HCT and MCV in the two groups were significantly lower than those before treatment, and the above indicators in the experimental group were significantly lower than those in the control group (P<0.05). The LSaO₂ levels in the two groups were significantly higher than those before treatment, and the AHI level was lower than that before the treatment, and the LSaO₂ in the experimental group was higher than that in the control group, and the AHI level in the experimental group was lower than that in the control group (both P<0.05). After treatment, the BNP, SP and DP in the two groups were significantly lower than those before treatment(P<0.05), and the above indexes in the experimental group were lower than that in the control group(P<0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group(P<0.05). Conclusion: ACEI and non-invasive ventilator assisted heart failure combined with OSAHS can improve the patient''s sleep disorder, sleep-disordered breathing, heart failure and high blood pressure, and has the value of clinical application.