• 上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院呼吸科（上海 200025）;

慢性心力衰竭發(fā)生率和死亡率均較高，夜間睡眠中反復(fù)發(fā)生的呼吸暫停和缺氧是促進(jìn)心力衰竭惡化的因素之一。中樞性睡眠呼吸暫停（central sleep apnea ,CSA）為起源于腦干呼吸控制中樞障礙的呼吸暫停，表現(xiàn)為呼吸減弱或停止。在普通人群中CSA患病率很低，但在慢性心力衰竭患者中則很高，且常常以陳-施呼吸（Cheyne-Stokes respiration，CSR），即CSR-CSA形式出現(xiàn)。CSA可進(jìn)一步加重心力衰竭，因此越來越受到重視[1]。

引用本文： 李慶云. 慢性心力衰竭與中樞性睡眠呼吸暫停. 中國呼吸與危重監(jiān)護(hù)雜志, 2010, 9(1): 4-6. doi: 復(fù)制

1. 睡眠呼吸暫停與心血管疾病專家共識(shí)寫作組.睡眠呼吸暫停與心血管疾病專家共識(shí).中華結(jié)核和呼吸雜志,2009,32(11):812-820.
2. Sin DD,Fitzgerald F, Parker JD,et al.Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure.Am J Respir Crit Care Med,1999,160:1101-1106.
3. Javaheri S.Heart failure and sleep apnea: emphasis on practical therapeutic options.Clin Chest Med,2003, 24:207-222.
4. 胡克,陳喜蘭,楊炯,等.老年人慢性充血性心力衰竭穩(wěn)定期的睡眠呼吸障礙.中華老年醫(yī)學(xué)雜志,2002,21:15-18.
5. Luo Q,Zhang HL,Tao XC,et al.Impact of untreated sleep apnea on prognosis of patients with congestive heart failure. Int J Cardiol. 2009 Apr 2. [Epub ahead of print].
6. Tkacova R,Hall MJ,Liu PP,et al.Left ventricular volume in patients with heart failure and Cheyne-Stokes respiration during sleep. Am J Respir Crit Care Med,1997,156:1549-1555.
7. Badr S.Central sleep apnea in patients with congestive heart failure.Heart Fail Rev,2009,14:135-141.
8. Xie A,Skatrud JB,Puleo DS,et al.Apnea-hypopnea threshold for CO2 in patients with congestive heart failure.Am J Respir Crit Care Med,2002,165:1245-1250.
9. Somers VK,White DP,Amin R,et al.Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing.J Am Coll Cardiol,2008,52:686-717.
10. Tamura A,Kawano Y,Kadota J.Carvedilol reduces the severity of central sleep apnea in chronic heart failure.Circ J,2009,73:295-298.
11. Bradley TD,Floras JS.Sleep apnea and heart failure: Part II:central sleep apnea. Circulation,2003,107:1822-1826.
12. Javaheri S,Ahmed M,Parker TJ,et al.Effects of nasal O2 on sleep-related disordered breathing in ambulatory patients with stable heart failure.Sleep,1999,22,1101-1106.
13. Sin DD,Logan AG,Fitzgerald FS,et al.Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation,2000,102:61-66.
14. Bradley TD,Logan AG,Kimoff RJ,et al.Continuous positive airway pressure for central sleep apnea and heart failure.N Engl J Med,2005,353:2025-2033.
15. Johnson KG,Johnson DC.Bilevel positive airway pressure worsens central apneas during sleep. Chest,2005,128:2141-2150.
16. Meza S,Mendez M,Ostrowski M,et al.Susceptibility to periodic breathing with assisted ventilation during sleep in normal subjects.J Appl Physiol,1998,85:1929-1940.
17. Arzt M,Bradley TD. Treatment of sleep apnea in heart failure.Am J Respir Crit Care Med,2006,173:1300-1308.
18. Philippe C,Stoïca-Herman M,Drouot X,et al.Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period.Heart,2006,92:337-342.
19. Javaheri S.Acetazolamide improves central sleep apnea in heart failure:a double-blind,prospective study.Am J Respir Crit Care Med,2006,173:234-237.
  1. 1. 睡眠呼吸暫停與心血管疾病專家共識(shí)寫作組.睡眠呼吸暫停與心血管疾病專家共識(shí).中華結(jié)核和呼吸雜志,2009,32(11):812-820.
  2. 2. Sin DD,Fitzgerald F, Parker JD,et al.Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure.Am J Respir Crit Care Med,1999,160:1101-1106.
  3. 3. Javaheri S.Heart failure and sleep apnea: emphasis on practical therapeutic options.Clin Chest Med,2003, 24:207-222.
  4. 4. 胡克,陳喜蘭,楊炯,等.老年人慢性充血性心力衰竭穩(wěn)定期的睡眠呼吸障礙.中華老年醫(yī)學(xué)雜志,2002,21:15-18.
  5. 5. Luo Q,Zhang HL,Tao XC,et al.Impact of untreated sleep apnea on prognosis of patients with congestive heart failure. Int J Cardiol. 2009 Apr 2. [Epub ahead of print].
  6. 6. Tkacova R,Hall MJ,Liu PP,et al.Left ventricular volume in patients with heart failure and Cheyne-Stokes respiration during sleep. Am J Respir Crit Care Med,1997,156:1549-1555.
  7. 7. Badr S.Central sleep apnea in patients with congestive heart failure.Heart Fail Rev,2009,14:135-141.
  8. 8. Xie A,Skatrud JB,Puleo DS,et al.Apnea-hypopnea threshold for CO2 in patients with congestive heart failure.Am J Respir Crit Care Med,2002,165:1245-1250.
  9. 9. Somers VK,White DP,Amin R,et al.Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing.J Am Coll Cardiol,2008,52:686-717.
  10. 10. Tamura A,Kawano Y,Kadota J.Carvedilol reduces the severity of central sleep apnea in chronic heart failure.Circ J,2009,73:295-298.
  11. 11. Bradley TD,Floras JS.Sleep apnea and heart failure: Part II:central sleep apnea. Circulation,2003,107:1822-1826.
  12. 12. Javaheri S,Ahmed M,Parker TJ,et al.Effects of nasal O2 on sleep-related disordered breathing in ambulatory patients with stable heart failure.Sleep,1999,22,1101-1106.
  13. 13. Sin DD,Logan AG,Fitzgerald FS,et al.Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation,2000,102:61-66.
  14. 14. Bradley TD,Logan AG,Kimoff RJ,et al.Continuous positive airway pressure for central sleep apnea and heart failure.N Engl J Med,2005,353:2025-2033.
  15. 15. Johnson KG,Johnson DC.Bilevel positive airway pressure worsens central apneas during sleep. Chest,2005,128:2141-2150.
  16. 16. Meza S,Mendez M,Ostrowski M,et al.Susceptibility to periodic breathing with assisted ventilation during sleep in normal subjects.J Appl Physiol,1998,85:1929-1940.
  17. 17. Arzt M,Bradley TD. Treatment of sleep apnea in heart failure.Am J Respir Crit Care Med,2006,173:1300-1308.
  18. 18. Philippe C,Stoïca-Herman M,Drouot X,et al.Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period.Heart,2006,92:337-342.
  19. 19. Javaheri S.Acetazolamide improves central sleep apnea in heart failure:a double-blind,prospective study.Am J Respir Crit Care Med,2006,173:234-237.