持续正压通气联合减重治疗阻塞性睡眠呼吸暂停低通气综合征伴肥胖患者的初步研究

发布时间：2018-01-18 08:51

  本文关键词：持续正压通气联合减重治疗阻塞性睡眠呼吸暂停低通气综合征伴肥胖患者的初步研究　出处：《上海医学》2017年02期 　论文类型：期刊论文

  更多相关文章： 阻塞性睡眠呼吸暂停低通气综合征 持续正压通气 减重 肥胖

【摘要】：目的探讨持续正压通气(CPAP)联合减重治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴肥胖患者的临床疗效。方法将60例OSAHS伴肥胖患者随机分入CPAP治疗组、减重治疗组和联合治疗组,每组20例,分别予CPAP、减重和两者联合治疗3个月。观察并比较3组患者治疗前后自体变化,如体重、BMI、颈围、腰围等;睡眠状态,如最长呼吸暂停时间(LAT)、呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(LS_aO_2)的改善情况;肺功能,如补呼气量占预计值的百分比(ERV%)、用力肺活量占预计值的百分比(FVC%)的改善情况。结果 CPAP治疗组患者治疗后的体重显著重于同组治疗前(P0.05),BMI、颈围、腰围均显著大于同组治疗前(P值均0.05);减重治疗组和联合治疗组患者治疗后的体重均显著轻于同组治疗前(P值分别0.05、0.01),BMI、颈围、腰围均显著小于同组治疗前(P值分别0.05、0.01);联合治疗组患者治疗前后的体重差值、BMI差值、颈围差值、腰围差值均显著大于减重治疗组(P值均0.01)。3组患者治疗后的LAT均显著短于同组治疗前(P值分别0.01、0.05),AHI均显著低于同组治疗前(P值均0.01),LS_aO_2均显著高于同组治疗前(P值分别0.01、0.05)。联合治疗组患者治疗前后的LAT差值、AHI差值、LS_aO_2差值均显著大于其他两组(P值均0.01)。CPAP治疗组患者治疗后的ERV%和FVC%均显著小于同组治疗前(P值均0.01),减重治疗组和联合治疗组患者治疗后的ERV%和FVC%均显著大于同组治疗前(P值均0.01)。联合治疗组患者治疗前后的ERV%差值和FVC%差值均显著大于减重治疗组(P值均0.01)。结论 OSAHS伴肥胖患者在接受CPAP治疗的同时,还应该接受在一定范围内的减重治疗。
[Abstract]:Objective to explore the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with continuous positive pressure ventilation (CPAP) combined with weight loss. Methods 60 OSAHS patients with obesity were randomly divided into CPAP treatment group. The weight loss group and the combined treatment group, 20 cases in each group, were treated with CPAP, weight loss and combined treatment for 3 months. The autologous changes of the patients before and after treatment were observed and compared, such as body weight, BMI, neck circumference. Waist circumference, etc. The improvement of sleep status, such as the longest apnea time, apnea hypopnea index (AHIHV), lowest arterial oxygen saturation (LSSAO _ 2); Lung function, such as the replacement expiratory volume as a percentage of the expected value. Results the weight of patients in CPAP treatment group after treatment was significantly focused on the same group before treatment P0.05 BMI, neck circumference. The waist circumference was significantly larger than that in the same group before treatment (P = 0.05). The weight loss group and the combined treatment group were significantly lighter than the same group before treatment P value of 0.05 ~ 0.01U BMI-neck circumference. The waist circumference was significantly lower than that in the same group before treatment (P < 0.05). The difference of body weight, BMI and neck circumference of patients in the combined treatment group before and after treatment. The difference of waist circumference was significantly higher than that of weight loss treatment group (P < 0.01). The LAT of group A was significantly shorter than that of group A (P = 0.01). AHI was significantly lower than that in the same group before treatment (P < 0.01). All of them were significantly higher than those in the same group before treatment (P < 0.01). The difference of LAT before and after treatment in the combined treatment group was significant. The difference of LS_aO_2 was significantly higher than that of the other two groups (P < 0.01). The ERV% and FVC% of the patients in the treatment group were significantly lower than those in the same group (P < 0.01). ERV% and FVC% in weight loss group and combined treatment group were significantly higher than those in the same group before treatment (P < 0.01). ERV% difference and FVC% difference were significantly higher in combined treatment group than in weight loss treatment group (P < 0.01). Conclusion the patients with OSAHS and obesity were treated with CPAP at the same time. You should also receive weight loss treatment to a certain extent.
【作者单位】： 青岛市市立医院东院区呼吸内科;青岛市市立医院东院区心内科;
【基金】：国家自然科学基金项目资助(81400024)
【分类号】：R589.2;R766
【正文快照】： 随着人们生活水平的提高,肥胖的发生率逐渐升高。有数据表明,全球将有7亿人口达到肥胖标准(BMI≥25kg/m2)[1],肥胖已经逐渐成为全球威胁人类健康的最常见代谢疾病之一。肥胖不仅与心血管疾病、高凝状态、肿瘤相关,还与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)相关。OSAHS是一种，

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