睡眠呼吸暂停低通气综合征患者自动滴定压力值及预估压力值的比较

发布时间：2019-05-08 22:49

【摘要】：目的：阻塞性睡眠呼吸暂停低通气综合征（Obstructive sleep apnea hypopneasyndrome OSAHS）的患者使用正确的持续正压通气压力更能有效改善白天嗜睡的症状及健康状况。选择合适的治疗压力是长期有效CPAP治疗的基础。接受长期CPAP治疗前需要确定最适合压力，这一过程被称为“压力滴定”。本研究目的在于比较自动型持续正压滴定压力值（automatic CPAP titrating pressurelevels ACPAPL)与预测公式得出压力值（predicting CPAP pressure levelsPCPAPL)的差异，并进一步分析影响差异的因素。方法：本文是一项回顾性研究，对象是96名在福建医科大学附属第一医院睡眠实验室被确诊为睡眠呼吸暂停低通气综合症的患者，且经临床医生诊断需要行CPAP治疗。本研究中使用百分之95的时间压力值作为自动滴定法的适合压力值即ACPAPL，另外根据体重指数（body mass index BMI）、颈围（neckcircumference NC）、睡眠呼吸暂停低通气指数（apnea/hypopnea index AHI）的公式求出预估的压力值即PCPAPL。我们利用配对T检验比较自动滴定法压力值和预估压力值两者之间是否有所不同。并利用Spearman‘s相关分析比较自动滴定法的压力值与一些影响因素即漏气数值、BMI、NC和AHI的关系。结果：收集96名病人压力数据之后，得出ACPAPL（11.44±2.56）明显高于PCPAPL（7.02±1.61），，且差异有统计学意义（p＜0.05)。87%病人在压力滴定过程中均有存在漏气的情况。自动滴定法的压力值与最大漏气（r=0.641P0．000），平均漏气（r=0.434P0．000），AHI （r=0.205p=0.046）有明显相关性，与最小漏气（p=0.733）、BMI（p=0.230）、NC（p=0.262）之间无明显相关。结论：ACPAPL明显高于PCPAPL。且ACPAPL与PCPAPL之间的差值波动范围较大，在压力滴定过程中漏气是一个普遍存在的现象。漏气数值是影响自动滴定法压力值的重要的因素之一。
[Abstract]:Aim: (Obstructive sleep apnea hypopneasyndrome OSAHS) patients with obstructive sleep apnea hypopnea syndrome (OSAS) are more effective in improving daytime somnolence symptoms and health by using correct continuous positive pressure (CPP) pressure. The choice of appropriate treatment pressure is the basis of long-term effective CPAP treatment. The most suitable pressure needs to be determined before long-term CPAP treatment, a process known as pressure titration. The purpose of this study is to compare the pressure value of automatic continuous barometric titration (automatic CPAP titrating pressurelevels ACPAPL) with the prediction formula to obtain the difference of pressure value (predicting CPAP pressure levelsPCPAPL), and to further analyze the factors affecting the difference. Methods: this study was a retrospective study of 96 patients with sleep apnea hypopnea syndrome diagnosed in the sleep laboratory of the first affiliated Hospital of Fujian Medical University. CPAP therapy was needed after clinical diagnosis. In this study, 95% of the time pressure value was used as the suitable pressure value of automatic titration, that is, ACPAPL, and (neckcircumference NC), according to body mass index (body mass index BMI), neck circumference. Sleep apnea hypopnea index (apnea/hypopnea index AHI) 's formula) to calculate the predicted pressure value, that is, PCPAPL. We use pairing T test to compare whether the pressure value of automatic titration is different from the predicted pressure value. Spearman's correlation analysis was used to compare the relationship between the pressure value of automatic titration and some influencing factors, namely, gas leakage value, BMI,NC and AHI. Results: after collecting pressure data of 96 patients, ACPAPL (11.44 卤2.56) was significantly higher than that of PCPAPL (7.02 卤1.61). The difference was statistically significant (p < 0.05). 87% of the patients had air leakage during pressure titration. The pressure value of automatic titration was significantly correlated with the maximum leakage (r=0.641P0.000) and mean leakage (r=0.434P0.000), AHI (r=0.205p=0.046), and with the minimum leakage (p = 0.733), BMI (p = 0.230), and the pressure value of the automatic titration was significantly correlated with the maximum gas leakage (), BMI () and the mean leakage (r=0.434P0.000), AHI (r=0.205p=0.046). There was no significant correlation between NC (p < 0. 262). Conclusion: ACPAPL is significantly higher than PCPAPL.. The difference between ACPAPL and PCPAPL fluctuates widely, and gas leakage is a common phenomenon in the process of pressure titration. Leakage value is one of the important factors that affect the pressure value of automatic titrimetric method.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R56

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