气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者心脏功能和血管内皮功能的影响

气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者心
脏功能和血管内皮功能的影响
新图叶
【期刊名称】《中国全科医学》
【年(卷),期】2017(20)20
【摘要】目的评价气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者心脏功能、血管内皮功能的影响.方法回顾性分析2013年1月-2016年1月在新疆医科大学第一附属医院治疗的OSAHS患者58例.给予12周气道正压通气治疗,停止治疗后观察1周.观察治疗前、治疗6周、治疗12周、停止治疗1周睡眠呼吸相关指标、心脏功能指标、血管内皮功能指标.结果 OSAHS 患者气道正压通气治疗前后血氧饱和度(SpO2)、SpO2<89%占睡眠时间百分比、Epworth嗜睡量表(ESS)评分、收缩压、舒张压、平均动脉压、中心动脉反射波增强指数、桡动脉脉搏波传导速度(PWV)、全身血管阻力(SVR)、肺血管阻力(PVR)比较,差异均有统计学意义(P<0.05);其中治疗6周收缩压、舒张压、平均动脉压、桡动脉PWV、SVR、PVR较治疗前降低,治疗12周SpO2较治疗前升高,治疗12周SpO2<89%占睡眠时间百分比、ESS评分、收缩压、舒张压、平均动脉压、中心动脉反射波增强指数、桡动脉PWV、SVR、PVR较治疗前降低(P<0.05);停止治疗1周SpO2、SpO2<89%占睡眠时间百分比、ESS评分、收缩压、舒张压、平均动脉压、中心动脉反射波增强指数、桡动脉PWV、SVR、PVR与治疗前比较,差异均无统计学意义(P>0.05).结论 OSAHS患者给予气道正压通气治疗12周后可以降低动脉压力、改善睡眠呼吸相关指标及血管内皮功能,但停止治疗1周后疗效很快消失.%Objective To evaluate the effect of positive airway pressure
ventilation on the cardiac function and vascular endothelial function in patients with obstructive sleep apnea hypopnea
syndrome(OSAHS).Methods A retrospective analysis was conducted on the data of 58 patients with OSAHS treated in the First Affiliated Hospital of Xinjiang Medical University from January 2013 to January 2016.All of them received 12-week positive airway pressure ventilation treatment,and after that,the treatment was stopped,and the conditions of them were observed for a week.The levels of markers associated with breathing during sleep,cardiac function and vascular endothelial function were measured before the treatment,at the 6th,12th weeks after treatment,and 1st week after stopping the treatment.Results Compared with before the treatment,the oxygen saturation(SpO2),percentage of total sleep time(TST) with SpO2 below 89%,Epworth Sleepiness Scale(ESS) score,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial
pressure(MAP),central aortic reflective wave pressure augmentation index,radial artery pulse wave conduction velocity(PWV),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR)in the OSAHS patients changed significantly(P<0.05),specifically,the levels of SBP,DBP,MAP,radial artery PWV,SVR and PVR measured at the 6th weeks after treatment were significantly lower than those measured before the treatment;the SpO2 measured at the 12th weeks after treatment was significantly increased while percentage of TST with SpO2 below 89%,ESS
score,SBP,DBP,MAP,central aortic reflective wave pressure augmentation index,radial artery PWV,SVR and PVR were significantly lower than those
measured before the treatment(P<0.05).However,after stopping the treatment for 1 week,the values of these markers were not significantly different from those measured before the treatment(P>0.05).Conclusion For OSAHS patients,12-week positive airway pressure ventilation treatment can reduce the arterial pressure,improve the levels of markers associated with breathing during sleep and vascular endothelial function,but the treatment response will be disappeared soon after stopping the treatment for 1 week.
【总页数】5页(P2459-2463)
【作者】新图叶
【作者单位】830054 新疆乌鲁木齐市,新疆医科大学第一附属医院呼吸三科
【正文语种】中文
【中图分类】R441.8
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