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

发布时间：2018-07-27 21:32

【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(SpO_2)、SpO_289%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(P0.05);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SpO_2较治疗前升高,治疗12周SpO_289%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(P0.05);停止治疗1周SpO_2、SpO_289%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(P0.05)。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。
[Abstract]:Objective to evaluate the effects of positive airway pressure on cardiac function and vascular endothelial function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 58 OSAHS patients treated in the first affiliated Hospital of Xinjiang Medical University from January 2013 to January 2016 were retrospectively analyzed. Positive airway pressure was given for 12 weeks and observed for 1 week after cessation of treatment. The indexes of sleep apnea, heart function and vascular endothelial function were observed before treatment, 6 weeks, 12 weeks, and 1 week after treatment. Results before and after positive airway pressure ventilation, the percentage of blood oxygen saturation (SpO_2) to sleep time in patients with OSAHS was 289%. (ESS) score, systolic blood pressure, diastolic blood pressure, mean arterial pressure and enhancement index of central artery reflex wave were evaluated by Epworth sleepiness scale. Pulse wave velocity of radial artery (PWV), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR) were significantly different (P0.05), among which systolic blood pressure, diastolic blood pressure, mean arterial pressure, radial artery PWV VVV VRV (PVR) were lower than those before treatment, and there was no significant difference between the two groups (P0.05), and the mean arterial pressure, systolic blood pressure, diastolic blood pressure at 6 weeks after treatment were lower than those before treatment. After 12 weeks of treatment, SpO_2 was significantly higher than that before treatment. At 12 weeks after treatment, the percentage of SpOs to sleep time was 28.9%, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (ABP), and enhancement index of central arterial reflex wave (CAR). PVR of PWV of radial artery was lower than that of before treatment (P0.05), the percentage of SPO2SpO289% to sleep time and ESS score, systolic blood pressure, diastolic blood pressure, mean arterial pressure, enhancement index of central artery reflex wave, PVR of PWVV SVRN PVR of radial artery were not significantly different from those before treatment (P0.05). Conclusion OSAHS patients treated with positive airway pressure for 12 weeks can reduce arterial pressure, improve sleep apnea related indexes and vascular endothelial function, but the curative effect quickly disappeared after one week.
【作者单位】：新疆医科大学第一附属医院呼吸三科;
【分类号】：R766

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