伊伐布雷定联合持续性气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征合并心律失常的临床效果

易景德 陈浩

[摘要]目的 观察伊伐布雷定联合持续性气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征合并心律失常的临床效果。方法 选取化州市人民医院2015年3月～2017年4月收治的112例阻塞性睡眠呼吸暂停综合征合并心律失常患者，使用持续性气道正压通气治疗者为对照组，联合使用伊伐布雷定和持续性气道正压通气治疗者为观察组，每组56例。两组均治疗30 d。比较两组的LAT、MAT、AHI、mSaO2，最高心率、最低心率、心律失常率。结果 治疗后，两组患者的LAT、MAT、AHI、mSaO2，最高心率、最低心率、心律失常率均有所改善，差异有统计学意义（P<0.05）。观察组治疗后的AHI明显低于对照组，mSaO2明显高于对照组，心律失常率与治疗前比较，明显低于对照组，差异均有统计学意义（P<0.05）。结论 伊伐布雷定联合持续性气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征合并心律失常的临床效果更显著，可有效改善患者的心律失常。

[关键词]阻塞性睡眠呼吸暂停低通气综合征；持续性气道正压通气；伊伐布雷定；心律失常

[中图分类号] R56 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0057-04

[Abstract] Objective To observe the clinical effect of Ivabradine combined with continuous positive airway pressure ventilation in the treatment of obstructive sleep apnea-hypopnea syndrome complicated with arrhythmia. Methods A total of 112 patients with obstructive sleep apnea-hypopnea syndrome with arrhythmia were treated in Huazhou People′s Hospital from March 2015 to April 2017 were selected. The patients treated with continuous positive airway pressure ventilation were selected as the control group， while the patients treated with Ivabradine combined with continuous positive airway pressure ventilation were selected as the observation group， and there were 56 patients in each group. The two groups were treated for 30 days. LAT， MAT， AHI， mSaO2， maximum heart rate， minimum heart rate， and arrhythmia rate were compared between the two groups. Results After treatment， the LAT， MAT， AHI， mSaO2， maximum heart rate， minimum heart rate， and arrhythmia rate in the two groups were improved compared with before treatment， and the differences were statistically significant （P<0.05）. After treatment， AHI of the observation group was significantly lower than that of the control group， mSaO2 was significantly higher than that of control group， average arrhythmia rate was significantly lower than that of the control group， and the differences were statistically significant （P<0.05）. Conclusion The clinical effect of Ivabradine combined with continuous positive airway pressure ventilation in the treatment of obstructive sleep apnea-hypopnea syndrome with arrhythmia is more significant， and it can effectively improve the arrhythmia of the patients.

[Key words] Obstructive sleep apnea-hypopnea syndrome； Continuous positive airway pressure ventilation； Ivabradine； Arrhythmia

阻塞性睡眠呼吸暫停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）是指睡眠中由于上气道反复阻塞，导致出现呼吸暂停、低氧血症及睡眠结构紊乱的一种疾病[1]。心律失常是OSAHS常见的一种并发症，严重时甚至有导致患者猝死的可能[2]。一般认为其与发病期间患者呼吸暂停引起的血氧饱和度下降或迷走神经紊乱等有关[3]。OSAHS在我国成年人中发病率为2%～4%[4]，尤其在男性、老年人、肥胖人士这些人群中发病率较高，而在OSAHS患者中40%都会出现心律失常[5]。OSAHS合并心律失常危害众多患者的生活和健康。本研究探讨伊伐布雷定联合持续性气道正压通气治疗OSAHS合并心律失常的效果，旨在探索一个新的治疗方案。

1资料与方法

1.1一般资料

选取化州市人民医院2015年3月～2017年4月收治的112例确诊为OSAHS合并心律失常患者，其中男68例，女44例；……