Abstract: Background　Pulmonary heart disease is a serious risk to public health，whose conventional treatments are not productive，yielding poor prognosis.Pulmonary heart disease induced by a major risk factor of obesity hypoventilation syndrome，may manifest more severe symptoms and poorer therapeutic outcome，which necessitates effective treatment schemes.Objective　To explore the value of noninvasive ventilation in the treatment of obesity hypoventilation syndrome related pulmonary heart disease.Methods　During the period from 2015 to 2017，25 patients with obesity hypopnea syndrome related pulmonary heart disease who were diagnosed and treated in the First People’s Hospital of Kashi were selected.All of them received conventional pharmacological treatment.During the study，6 cases were excluded（4 dropped out due to failing to adhere to treatment and reexamination，1 died suddenly，and 1 was lost to follow-up），the remaining 19 cases﹝8 received post-discharge 24-month noninvasive positive pressure ventilation （NPPV group），and 11 received post-discharge 24-month constant inhalation of low-volume oxygen（control group）﹞were included for further analysis.The parameters such as body mass index （BMI），neck circumference，abdominal circumference，pulmonary artery pressure，partial pressure of oxygen （PaO2），partial pressure of carbon dioxide （PaCO2） and apnea-hypopnea index （AHI） were compared between the two groups after 3，6，12 and 24 months of post-discharge treatment.Pearson correlation analysis was used to explore the relationship between BMI and PaCO2.Results　In the NPPV group，mean BMI，neck circumference，abdominal circumference，pulmonary artery pressure，PaCO2，and AHI decreased while PaO2 increased with the prolongation of treatment time （P<0.05）；In the control group，mean BMI，abdominal circumference，pulmonary artery pressure，PaCO2，and AHI decreased while PaO2 increased with the prolongation of treatment time （P<0.05）.After 24 months of treatment，the NPPV group had lower mean neck circumference，abdominal circumference，pulmonary artery pressure，PaCO2 and AHI but higher mean PaO2 than the control group（P<0.05）.Pearson correlation analysis showed that BMI had a linear correlation with PaCO2（r=1.261，P<0.001）.Conclusion　Both long-term noninvasive positive pressure ventilation and constant inhalation of low-volume oxygen can improve BMI，neck circumference，abdominal circumference，pulmonary artery pressure，PaCO2，AHI and PaO2 of the patients，but the former has better effect in improving PaO2，PaCO2，AHI，pulmonary artery systolic pressure，and reducing abdominal and neck circumferences.

Key words: Pulmonary heart disease, Obesity hypopnea syndrome, Non-invasive ventilation, Therapy

摘要： 背景　肺心病是严重影响人民群众健康的疾病，目前的常规治疗方法效果都不佳，预后极差。肥胖低通气综合征是引起肺心病的重要原因，且症状更严重，治疗效果更差，迫切需要寻找有效治疗该病的方法。目的　探讨无创正压通气对肥胖低通气综合征相关肺心病的治疗价值。方法　选择2015年—2017年在喀什地区第一人民医院诊治的肥胖低通气综合征相关肺心病患者25例作为研究对象，其中4例患者不能坚持治疗和复查退出本研究，有1例猝死，1例失联，最终纳入研究对象为19例。患者均给予常规药物治疗，出院后选择无创正压通气治疗并坚持24个月的8例患者为无创正压通气组，出院后选择持续低流量吸氧治疗并坚持24个月的11例患者为对照组。比较两组患者治疗3个月、6个月、12个月、24个月后体质指数（BMI）、颈围、腹围、肺动脉收缩压、血氧分压（PaO2）、二氧化碳分压（PaCO2）、低通气指数（AHI）的变化情况。采用Pearson相关性分析探讨BMI与PaCO2之间的关系。结果　无创正压通气组患者BMI、颈围、腹围、肺动脉收缩压、PaCO2、AHI随治疗时间的延长而降低，PaO2随治疗时间的延长而增加（P<0.05）；对照组患者BMI、腹围、肺动脉收缩压、PaCO2、AHI随治疗时间的延长而降低，PaO2随治疗时间的延长而增加（P<0.05）。治疗24个月后，无创正压通气组颈围、腹围、肺动脉收缩压、PaCO2、AHI低于对照组，PaO2高于对照组（P<0.05）。Pearson相关性分析结果显示，BMI与PaCO2具有线性相关关系（r=1.261，P<0.001）。结论　长期无创正压通气和持续低流量吸氧治疗均可以改善患者的BMI、颈围、腹围、肺动脉收缩压、PaCO2、AHI、PaO2，长期无创正压通气治疗较持续低流量吸氧治疗更能有效改善患者的PaO2、PaCO2、AHI、肺动脉收缩压，降低患者腹围、颈围。

关键词: 肺心病, 肥胖低通气综合征, 无创通气, 治疗