摘要

目的:确定卡托普利和氧气对轻中度心衰患者睡眠质量的影响。设计:一项开放观察性研究。患者:12例纽约心脏协会II-III级心力衰竭患者在基线时进行研究。其中9例患者在卡托普利治疗1个月后进行检查;其中9名患者在补充氧气的一个晚上分别进行了评估。主要观察指标:多导睡眠描记术、夜间血氧饱和度测定和视觉模拟评分的主观睡眠评估。结果:所有基线研究均存在睡眠异常。8例患者在卡托普利治疗后获得完整的多导睡眠图。浅睡眠(阶段1和阶段2)减少(平均(SEM) 61%(8)% ~ 48%(6)%实际睡眠时间，P < 0.05)，而慢波睡眠(阶段3和阶段4)和快速眼动睡眠(REM)增加(25%(6)% ~ 31%(5)%，14%(2)% ~ 21%(5)%实际睡眠时间，P < 0.05)。呼吸暂停发作次数(242(59)~ 118(30)次，P < 0.05)、去饱和事件(171(60)~ 73(37)次，P < 0.05)、觉醒次数(33(5)~ 18(3)次，P < 0.01)减少。 Visual analogue scores of sleep quality increased 49(5) to 69(5), P < 0.01). Complete polysomnograms were obtained in 7 patients treated with oxygen. Light sleep duration was reduced (55% (7)% to 42%(5)% actual sleep time, P < 0.05) and slow wave sleep increased (30%(5)% to 38%(6)% actual sleep time, P < 0.05). REM sleep duration was not significantly different. Total arousals (33(6)% to 20(2) P < 0.05), desaturation events (140(33) to 38(10), P < 0.01), and apnoeic episodes (212(53) to 157(33), P < 0.05) were reduced. Visual analogue scores of sleep quality were unchanged. CONCLUSIONS--Captopril and oxygen may improve sleep quality and reduce nocturnal desaturation in patients with mild to moderate cardiac failure. Improved sleep quality could explain the reduction in daytime symptoms seen after treatment in patients with chronic heart failure.