复杂性睡眠呼吸暂停综合征患者临床特征及适应性伺服通气的治疗效果

发布时间：2019-05-29 20:15

【摘要】：目的观察复杂性睡眠呼吸暂停综合征(Comp SAS)的临床特征,评价适应性伺服通气(ASV)对Comp SAS的疗效。方法收集接受持续气道正压通气(CPAP)治疗的成年中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者303例。根据指南将303例患者分为单纯OSAHS组和Comp SAS组。Comp SAS组患者进行ASV治疗。比较两组患者的年龄、性别、体重、体质指数、合并症及诊断性多导睡眠图监测参数及呼吸机治疗时参数。结果接受CPAP治疗的成年中重度OSAHS患者中,Comp SAS患者所占比例为6.2%。Comp SAS组患者高血压发生率为73.6%,心力衰竭的发生率为26.3%,均高于单纯OSAHS组患者的42.9%和7%(P0.05)。与治疗前相比,经CPAP治疗的Comp SAS组患者中枢性睡眠呼吸暂停指数(CAI)明显升高(P0.05),分别为(9.50±2.94)次/h vs(2.95±2.88)次/h;Comp SAS组患者ASV治疗与CPAP治疗相比,前者睡眠效率明显提高,Ⅲ期睡眠所占比例明显升高;呼吸暂停低通气指数(AHI)、CAI明显降低;LSp O2显著增加。结论 Comp SAS患者中高血压、心力衰竭的发生率更高,混合性睡眠呼吸暂停指数更高。与CPAP相比,ASV治疗更能有效增加Comp SAS患者深睡眠,降低AHI和CAI,纠正低氧血症。
[Abstract]:Objective to observe the clinical characteristics of complex sleep apnea syndrome (Comp SAS) and evaluate the efficacy of adaptive servo ventilation (ASV) in the treatment of Comp SAS. Methods 303 adult patients with moderate and severe obstructive sleep apnea hypopnea syndrome (OSAHS) treated with continuous positive airway pressure (CPAP) were collected. According to the guidelines, 303 patients were divided into simple OSAHS group and Comp SAS group. Comp SAS group was treated with ASV. The age, sex, body weight, body mass index, complications and diagnostic polysomnography monitoring parameters and ventilator treatment parameters were compared between the two groups. Results the incidence of hypertension and heart failure in 6.2%.Comp SAS group and heart failure group were 73.6% and 26.3%, respectively. Results the incidence of hypertension and heart failure in 6.2%.Comp SAS group was 73.6% and 26.3%, respectively. They were higher than those in OSAHS group (42.9% and 7%) (P 0.05). Compared with before treatment, the central sleep apnea index (CAI) in Comp SAS group treated with CPAP was significantly higher than that before treatment (P 0.05), which was (9.50 卤2.94) times / h vs (2.95 卤2.88 times / h, respectively. Compared with CPAP treatment, the sleep efficiency of ASV group was significantly higher than that of CPAP group, the proportion of stage III sleep was significantly increased, (AHI), CAI was significantly decreased, and LSp O 2 was significantly increased in ASV group. Conclusion the incidence of hypertension, heart failure and mixed sleep apnea index are higher in patients with Comp SAS. Compared with CPAP, ASV treatment can effectively increase deep sleep and decrease AHI and CAI, to correct hypoxia in Comp SAS patients.
【作者单位】：民航总医院呼吸内科;
【基金】：首都卫生发展科研专项项目(编号:首发2011-6021-01)
【分类号】：R766

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