莫达非尼对阻塞性睡眠呼吸暂停综合征患者持续气道正压通气治疗后残余嗜睡的疗效及安全性分析

发布时间：2018-01-25 02:46

本文关键词： 残余白天嗜睡阻塞性睡眠呼吸暂停综合征持续气道正压通气莫达非尼　出处：《南京医科大学学报(自然科学版)》2015年11期 　论文类型：期刊论文

【摘要】：目的 :评价莫达非尼治疗阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)经有效持续气道正压通气(continuous positive airway pressure,CPAP)治疗后仍残余嗜睡的疗效及安全性。方法:随机选取自2014年7月—12月就诊于南京医科大学第一附属医院睡眠呼吸障碍中心,患有中重度OSAS且经有效CPAP治疗仍残余白天嗜睡的32例男性患者,Epworth嗜睡量表(Epworth sleepiness scale,ESS)评分10分。研究包括3个阶段:T1阶段行基线检测并将受试者随机分配至莫达非尼组和安慰剂组;T2阶段口服莫达非尼或安慰剂,每日1次,剂量为100 mg,共7 d;T3阶段口服莫达非尼或安慰剂,每日1次,剂量为200 mg,共28 d,T3阶段的最后1 d行最终评价。T1、T3阶段的检测指标包括:血常规、血生化、尿常规、心电图检测,夜间多导睡眠监测、多发小睡实验,此外在T1、T2、T3阶段持续检测ESS。结果:药物治疗前后所有受试者呼吸暂停指数、CPAP每晚使用时间无明显变化。药物治疗后,与安慰剂组比较,莫达非尼治疗组平均入睡潜伏期延长、ESS评分下降,差异均有统计学意义(P均0.05);此外,在莫达非尼治疗组中,T3(200 mg剂量)较T2(100 mg剂量),ESS下降更加显著(F=0.719,P=0.015);莫达非尼治疗组有62.5%患者出现口干、恶心、头痛等不良反应,所有不良反应均介于轻中度之间,差异无统计学意义(P=0.41)。结论:莫达非尼可以改善中重度OSAS患者经有效CPAP治疗仍残余的白天嗜睡,患者对该药具有良好的耐受性。
[Abstract]:Objective: to evaluate the effect of modafinil on obstructive sleep apnea syndrome in patients with obstructive sleep apnea syndrome (OSAS). OSAS) continuous positive airway pressure via effective continuous positive airway pressure (CPAP). Methods: from July 2014 to December, we randomly selected sleep apnea center of the first affiliated hospital of Nanjing Medical University. There were 32 male patients with moderate and severe OSAS who were treated with effective CPAP and remained daytime drowsiness. Epworth somnolence scale, Epworth sleepiness scale. The study consisted of three stages: T1: baseline test and randomized assignment to the modafenib group and the placebo group. T2-phase oral modafinil or placebo, once a day, at a dose of 100 mg for 7 days; In the T3 phase, modafinil or placebo was administered once a day at a dose of 200 mg, and the final evaluation was performed on the last day of the 28 d T 3 phase. The indicators of T3 stage included: blood routine, blood biochemistry, urine routine, electrocardiogram test, nocturnal polysomnography monitoring, multiple napping test, in addition to T1T 2. Results: there was no significant change in apnea index (CPAP) in all subjects before and after medication. The scores of ESS in the modafenib group were significantly lower than those in the control group (P < 0.05). In addition, in the modafenib treatment group, the dose of T3 + 200 mg) was significantly lower than that of T2 + 100mg / L, and the decrease of ESS was more significant than that of T2 + 100mg / kg. In the modafinil treatment group, 62.5% patients developed dry mouth, nausea, headache and other adverse reactions, all the adverse reactions were between mild and moderate. Conclusion: modafenib can improve daytime sleepiness in patients with moderate and severe OSAS after effective CPAP treatment, and the patients have good tolerance to the drug.
【作者单位】：南京医科大学第一附属医院呼吸内科;南京医科大学附属无锡市人民医院呼吸科;
【基金】：江苏省科技创新与成果转化专项基金(BL2012012)
【分类号】：R766
【正文快照】： 214043)南京医科大学学报阻塞性睡眠呼吸暂停综合征(obstructive sleepapnea syndrome,OSAS)是一种较常见的慢性疾病,以夜间反复发生的部分或完全上气道塌陷为特点,引起低通气和(或)呼吸暂停事件,导致睡眠过程中断、间歇性缺氧及微觉醒的反复发生,从而引起夜间睡眠结构紊乱、

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