Zhonghua yi xue za zhi · 2006
[Efficacy of adaptive pressure support servo-ventilation in patients with congestive heart failure and Cheyne-Stokes respiration].
Аннотация на английскомСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Zhang Xi-long, Yin Kai-sheng, Jiang Shi-sen, Li Xin-li, Jia En-zhi, Su Mei
Аннотация
OBJECTIVE: To investigate the efficacy of adaptive pressure support servo-ventilation (APSSV) on Cheyne-Stokes respiration (CSR) in congestive heart failure (CHF).
METHODS: 14 patients with CHF and CSR were recruited. During sleep, oxygen therapy and APSSV were separately performed. Comparison before and after each treatment was made for the following items: a) parameters of sleep respiration, sleep structure and quality; b) cardiac function index such as left ventricle ejection fraction (LVEF) and 6 minutes' walking distance; c) plasma endothelin-1 (ET-1) levels.
RESULTS: Compared with the baseline level before treatment, the apnea hypopnea index significantly decreased during oxygen therapy (P < 0.05) and further declined during APSSV (P < 0.01); on the contrary, the lowest pulse oxygen saturation increased during oxygen therapy (P < 0.05) and further elevated during APSSV (P < 0.01). Compared with arousal index before treatment, it was significantly lower during oxygen therapy (P < 0.05) and the lowest during APSSV (P < 0.01). Compared with both during oxygen therapy and before treatment, during APSSV the percentage ofI + II stage sleep time/total sleep time was significantly lower while the percentage of III + IV stage sleep time/total sleep time was significantly higher. The above percentages during oxygen therapy and before treatment showed no significant difference (P < 0.05). LVEF was significantly higher during APSSV than during oxygen therapy and before treatment (P < 0.05). Six minutes' walking distance was the shortest before treatment and the longest during APSSV. There was a significant difference among that before treatment, during oxygen therapy and APSSV (all P < 0.01). The plasma ET-1 level showed significantly lower during APSSV than that before and during oxygen treatment (P < 0.05), but no significant difference between the levels before and during oxygen treatment (P > 0.05).
CONCLUSION: APSSV, more effective than oxygen therapy, is of great clinical significance in improvement of CHF and its prognosis by a better sleep and breathing.
METHODS: 14 patients with CHF and CSR were recruited. During sleep, oxygen therapy and APSSV were separately performed. Comparison before and after each treatment was made for the following items: a) parameters of sleep respiration, sleep structure and quality; b) cardiac function index such as left ventricle ejection fraction (LVEF) and 6 minutes' walking distance; c) plasma endothelin-1 (ET-1) levels.
RESULTS: Compared with the baseline level before treatment, the apnea hypopnea index significantly decreased during oxygen therapy (P < 0.05) and further declined during APSSV (P < 0.01); on the contrary, the lowest pulse oxygen saturation increased during oxygen therapy (P < 0.05) and further elevated during APSSV (P < 0.01). Compared with arousal index before treatment, it was significantly lower during oxygen therapy (P < 0.05) and the lowest during APSSV (P < 0.01). Compared with both during oxygen therapy and before treatment, during APSSV the percentage ofI + II stage sleep time/total sleep time was significantly lower while the percentage of III + IV stage sleep time/total sleep time was significantly higher. The above percentages during oxygen therapy and before treatment showed no significant difference (P < 0.05). LVEF was significantly higher during APSSV than during oxygen therapy and before treatment (P < 0.05). Six minutes' walking distance was the shortest before treatment and the longest during APSSV. There was a significant difference among that before treatment, during oxygen therapy and APSSV (all P < 0.01). The plasma ET-1 level showed significantly lower during APSSV than that before and during oxygen treatment (P < 0.05), but no significant difference between the levels before and during oxygen treatment (P > 0.05).
CONCLUSION: APSSV, more effective than oxygen therapy, is of great clinical significance in improvement of CHF and its prognosis by a better sleep and breathing.