基于Meta分析方法评价CPAP治疗OSAHS合并高血压疗效

发布时间：2018-06-15 20:39

  本文选题：OSAHS + 高血压　； 参考：《昆明理工大学》2017年硕士论文

【摘要】：OSAHS疾病严重影响着患者的睡眠质量和生命健康,同时也造成了重大的社会经济、家庭幸福方面的不良影响。因此,CPAP治疗效果的疗效评价对临床决策十分重要。利用具有能对同课题的诸多研究结果进行综合统一优势的Meta分析方法评价CPAP联合常规降压药物对中国OSAHS合并高血压患者的综合疗效,为国内相关临床医生提供一种参考治疗方法。方法计算机检索中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、中国学术期刊全文数据库(CNKI)、万方资源数据库,重庆维普网等电子数据库并手工检索相关期刊,查找CPAP治疗对OSAHS合并高血压患者综合疗效影响方面的临床随机对照试验(RCT),对符合条件的RCT,逐个评价入选研究的质量,提取纳入文献基本研究资料,选取RevMan5.3软件为分析工具进行Meta分析,以Meta分析中的合并效应统计参数探讨CPAP联合常规降压药物的治疗效果。共纳入13篇文献。Meta分析数据显示:各项指标差异均具有统计学意义[AHI:WMD=-25.19,95%CI(-34.05,-16.33),P0.00001;LSa02:WMD=17.57,95%CI(11.16,23.98),P0.00001;白天平均收缩压:WMD=-8.26,95%CI(-11.18,-5.34),P0.00001;白天平均舒张压:WMD=-6.42,95%CI(-8.25,-4.60),P0.00001;夜间平均收缩压:WMD=-12.92,95%CI(-19.65,-6.19),P0.0002;夜间平均舒张压:WMD=-6.31,95%CI(-8.53,-4.09),P0.00001;24h 平均收缩压:WMD=-10.28,95%CI(-14.08,-6.48),P0.00001;24h 平均舒张压:WMD=-6.99,95%CI(-8.88,-5.09),P0.00001;],提示CPAP联合常规降压药物治疗后OSAHS合并高血压患者各项指标改善程度较对照组(常规药物治疗)均有明显提升。漏斗图大致对称,存在发表偏倚可能性很小。CPAP联合常规降压药物治疗对我国OSAHS合并高血压患者有显著的疗效。为进一步明确CPAP治疗OSAHS合并难治性高血压的降压疗效,以期更好地应用于临床,本课题针对以上问题再次做了 Meta分析。系统性的评价CPAP对OSAHS低通气综合症OSAHS合并难治性高血压患者血压的影响。计算机检索 ScienceDirect、Cochrane Library、PubMed、Web of Science等电子数据库并手工检索相关期刊,查找CPAP治疗对OSAHS合并难治性高血压患者血压影响的临床随机对照试验(RCT),对符合条件的RCT,逐一对纳入研究的质量进行评价,提取纳入文献的基本研究资料,选取RevMan5.3和R 3.2.2软件为分析工具进行Meta分析。共纳入7篇RCT研究。Meta分析结果显示:CPAP治疗后OSAHS合并难治性高血压患者24h平均收缩压/舒张压,较对照组有显著改善,差异具有统计学意义。24h平均收缩压/舒张压合并效应统计结果分别为:[WMD=-5.36,95%CI(-8.60,-2.11),P=0.001;I270%]/[WMD=-4.21,95%CI(-6.39,-2.04),P=0.00001;I2 79%];CPAP 治疗可有效地降低OSAHS合并难治性高血压患者的血压。以上两项Meta分析,均表明CPAP治疗OSAHS合并高血压具有一定疗效,并且在对国内的OSAHS合并高血压患者的效果更为显著,而对于CPAP治疗OSAHS合并难治性高血压则提示配合常规降压药物治疗效果将会更好。
[Abstract]:OSAHS disease seriously affects the patient's sleep quality and life health, but also has a great impact on social economy and family happiness. Therefore, the evaluation of therapeutic effect of CPAP is very important for clinical decision. To evaluate the comprehensive efficacy of CPAP combined with conventional antihypertensive drugs in OSAHS patients with hypertension in China, a meta-analysis method was used to evaluate the comprehensive advantages of the results of many studies on the same subject. To provide a reference treatment for the relevant clinicians in China. Methods the Chinese biomedical literature database (CBM), the Cochrane Library PubMeddatabase, the Chinese academic journal full-text database (CNKI), the Wanfang resource database and the Chongqing Weipu Web were searched by computer and the related journals were searched manually. To find out the effect of CPAP therapy on the comprehensive curative effect of OSAHS patients with hypertension, a randomized controlled trial was conducted to evaluate the quality of the selected studies one by one for the eligible RCTs, and to extract and incorporate the basic research materials into the literature. Revman 5.3 software was selected as a tool for meta-analysis. The combined effect of CPAP combined with conventional antihypertensive drugs was evaluated by the statistical parameters of combined effects in meta-analysis. 鍏辩撼鍏，

本文编号：2023556