葡萄籽原花青素对中老年OSAHS患者肺通气及炎症水平的影响

发布时间：2018-05-16 22:14

本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 葡萄籽原花青素　；参考：《实用预防医学》2016年07期

【摘要】：目的观察葡萄籽原花青素(grape seed proanthocyanidin extract,GSPE)对中老年阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者肺通气及炎症水平的影响。方法 2012年12月-2014年12月为华北理工大学附属医院呼吸内科确诊的108例中老年OSAHS患者随机分为对照组(36例),GSPE A组(36例)与GSPE B(36例)。对照组给予持续气道正压通气(CPAP)治疗;GSPE A组和GSPE B组在此基础上分别给予高剂量(100mg/粒,2粒/次)和低剂量(100 mg/粒,1粒/次)GSPE口服治疗。在治疗前和治疗后8周检测外周血白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平,结合多导睡眠图监测(polysonmography,PSG)监测最长低通气时间(the maximum hypopnea time,MHT)、低通气指数(low ventilation index,HI)、最长呼吸暂停时间(the longest apnea time,LAT)、呼吸暂停指数(apnea index,AI)和呼吸紊乱指数(respiratory disturbance index,RDI)、夜间最低血氧饱和度(lowest oxygen saturation,LSa O_2)。采用SPSS17.0软件进行统计分析。结果治疗前,三组基本临床资料、PSG检测指标、血清IL-6、TNF-α水平差异无统计学意义(P0.05);与治疗前比较,对照组治疗后的MHT、HI、LAT、AI和RDI、LSa O_2均显著改善,差异有统计学意义(P0.05);GSPE A组:治疗后的MHT、HI、LAT、AI、RDI、LSa O_2较治疗前显著改善,差异有统计学意义(P0.05);GSPE B组:治疗后的MHT、HI、RDI、LSa O_2均较治疗前显著改善,差异有统计学意义(P0.05)。LAT、AI虽有所改善,但差异无统计学意义(P0.05);治疗后,GSPE A组和GSPE B组的MHT、HI、LAT、AI、RDI和LSa O_2的改善程度优于对照组,差异有统计学意义(P0.05);GSPE A组MHT、HI、LAT、AI、RDI和LSa O_2的改善程度优于对照组GSPE B组,差异有统计学意义(P0.05);治疗后,GSPE A组和GSPE B组中IL-6(20.10±5.96和26.33±6.38 vs.33.14±7.22)、TNF-α(32.42±6.33和42.80±5.48 vs.51.32±4.28)低于对照组,差异有统计学意义(P0.05);GSPE A组治疗总有效率(88.2%)显著高于对照组(70.5%)和GSPE B组(81.8%),差异有统计学意义(P0.05)。结论 GSPE可有效的降低IL-6、TNF-α水平,提高中老年OSAHS患者的治疗效果。
[Abstract]:Objective to observe the effects of grape seed procyanidin seed proanthocyanidin extract (GSPE) on pulmonary ventilation and inflammation in elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods from December 2012 to December 2014, 108 middle-aged and elderly patients with OSAHS were randomly divided into control group (n = 36) and GSPE group (n = 36). The control group was treated with continuous positive airway pressure ventilation (CPAP). On this basis, the GSPE group and the GSPE B group were treated with high dose of 100 mg / L and low dose of 100 mg / L of GSPE respectively. The levels of interleukin-6 (IL-6) and tumor necrosis factor- 伪 (TNF- 伪) in peripheral blood were measured before and 8 weeks after treatment. Polysomnography (PSG) was used to monitor the maximum hypopnea time of hypopnea, the hypopnea index, the longest apnea ventilation index, the longest apnea time, the apnea index, the respiratory disorder index, the respiratory disturbance index, and the lowest oxygen saturation at night. SPSS17.0 software was used for statistical analysis. Results before treatment, there was no significant difference in the levels of serum IL-6 and TNF- 伪 between the three groups before and after treatment, and there was no significant difference in the levels of serum IL-6 and TNF- 伪 between the control group and the control group after treatment, both MHT HIHI LATA AI and RDI LSa O 2 were significantly improved after treatment, and there was no significant difference in the level of IL-6 and TNF- 伪 between the three groups before and after treatment. There was significant difference in GSPE group (P 0.05): after treatment, there was a significant improvement in MHTHHIHI-LATA LSAO2 compared with that before treatment, and the difference was statistically significant. The difference was statistically significant (P 0.05): after treatment, the MHTHU HIRDILSAO _ 2 was significantly improved than that before treatment, and the difference was statistically significant (P 0.05) .LATA AI was improved, and there was no significant difference between the two groups, and the difference was significant (P 0.05), and the difference was significant (P < 0.05), and the difference was significant (P < 0.05). However, there was no significant difference between GSPA group and GSPE B group (P 0.05). The improvement of LSa O 2 and LSa O 2 in GSPA group and GSPE B group was better than that in control group. The difference was statistically significant. The improvement of LSa O 2 and LSa O 2 in GSPE A group was better than that in GSPE B group. After treatment, the IL-6(20.10 卤5.96 and 26.33 卤6.38 vs.33.14 卤7.22 vs.33.14 of TNF- 伪 in the GSPA group and GSPE B group were significantly lower than those in the control group (32.42 卤6.33 and 42.80 卤5.48 vs.51.32 卤4.28), and the total effective rate in the P0.05GSPE A group was significantly higher than that in the control group (70.5.5%) and in GSPE B group (81.8%). Conclusion GSPE can effectively reduce the level of IL-6 TNF- 伪 and improve the therapeutic effect of OSAHS.
【作者单位】：华北理工大学附属医院呼吸内科;
【基金】：河北省医学科学研究重点课题(ZD20150515)
【分类号】：R766

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