持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合症患者血压影响的Meta分析

发布时间：2018-06-04 16:53

本文选题：阻塞性睡眠呼吸低通气综合征 + 持续气道正压通气　；参考：《重庆医科大学》2013年硕士论文

【摘要】：目的：综合评价持续气道正压通气治疗（Continuous positive airwaypressure，CPAP）对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleepapnea-hypopnea syndrome,OSAHS)患者血压的影响。方法：全面检索Pubmed、Embase、Web of science、Cochrance、相关期刊论文、万方等电子数据库。检索时限截止至2013年3月7日。对符合条件的随机对照试验（RCT）进行资料提取、质量评价，进行异质性检验，并根据血压监测方法不同及纳入研究人群差异进行亚组分析，采用Revman5.1软件对各研究结果进行数据合并，计算合并后WMD值及95%CI，对合并后WMD进行统计学检验。对各研究结果进行敏感性分析，评价Meta分析结果的稳定性。结果：共纳入10个RCT，包括1182例患者。Meta分析结果显示：收缩压组和舒张压组异质性检验分别为：（P=0.26，I~2=20%）、（P=0.41，I~2=3%），因此采用固定效应模型分别进行合并。治疗组和对照组之间有显著统计学意义：（P＜0.00001）。提示CPAP治疗可以有效降低OSAHS患者的血压。将使用动态血压计监测血压的6个研究行亚组分析，异质性检验在收缩压和舒张压组分别为：（P=0.18，I~2=34%）、（P=0.66，I~2=0%），，因此采用固定相应模型合并。结果显示治疗组和对照组之间有统计学意义：（P＜0.00001），提示CPAP治疗可以有效降低OSAHS患者的血压。最后将以高血压患者为研究对象的4个研究进行Meta分析，收缩压组和舒张压组异质性分析显示：（P=0.64，I~2=0%），（P=0.52，I~2=0%），亦采用固定效应模型合并分析，治疗组和对照组之间有统计学意义（P=0.002），结果提示CPAP治疗对高血压患者同样可以有效降低血压。结论：CPAP治疗可以有效降低OSAHS患者的血压。
[Abstract]:Objective: to evaluate the effect of continuous positive airway pressure (CPAP) on blood pressure in patients with obstructive sleepapnea-hypopnea syndrome (OSAHS). Methods: Pubmedus Embase Web of Science Cochrance, full text Database of Chinese Journals, Electronic Database of Wanfang and other electronic databases were searched. The time limit for retrieval is up to March 7, 2013. Data extraction, quality evaluation, heterogeneity test and subgroup analysis were carried out according to the different blood pressure monitoring methods and the differences of the people involved in the RCTs. The Revman5.1 software was used to combine the data of the research results, the WMD value and 95% CI were calculated, and the combined WMD was tested statistically. Sensitivity analysis was carried out to evaluate the stability of Meta analysis results. Results: a total of 10 RCTs were included, including 1182 patients. Meta-analysis showed that the heterogeneity test of systolic blood pressure group and diastolic blood pressure group was 0.26% P0. 26 and 20% respectively. There was significant difference between the treatment group and the control group (P < 0.00001). The results suggest that CPAP therapy can effectively reduce the blood pressure of OSAHS patients. Six blood pressure monitoring studies using dynamic sphygmomanometer were performed subgroup analysis. The heterogeneity test in systolic blood pressure group and diastolic blood pressure group were 0. 18 and 0. 18%, respectively. The results showed that there was a significant difference between the treatment group and the control group (P < 0.00001), suggesting that CPAP treatment can effectively reduce the blood pressure of OSAHS patients. Finally, Meta analysis was carried out in 4 studies of hypertension patients. The heterogeneity analysis of systolic and diastolic blood pressure groups showed that the blood pressure was 0.64% and 0.52%, and the fixed effect model was also used to combine the analysis. There was significant difference between the treatment group and the control group. The results showed that CPAP treatment could also effectively lower blood pressure in patients with hypertension. Conclusion the blood pressure of patients with OSAHS can be effectively reduced by the treatment of 1: CPAP.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R766

【参考文献】