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目的探讨持续气道正压通气(CPAP)治疗老年阻塞性睡眠呼吸暂停综合征(OSAS)患者发生心脑血管事件的远期作用。方法选择本院中重度OSAS老年患者120例,对所有患者进行定期随访并记录患者的心脑血管事件。同时进行OSAS患者心脑血管事件相关因素的调查分析。结果 120例中重度OSAS老年患者中,坚持进行CPAP治疗的患者共39例,作为实验组;未坚持进行CPAP治疗的患者81例,作为对照组。实验组患者心脑血管事件的发生率为12.82%(5/39),对照组发生率为46.91%(38/81)。实验组患者心脑血管事件发生率明显低于对照组,差异有统计学意义(χ2=13.31,P<0.05)。经Kaplan-Meier生存分析结果显示,当随访时间越长,对照组发生心脑血管事件的风险显著高于实验组,差异有统计学意义(χ2=16.5,P=0.005)。为分析OSAS患者心脑血管事件的影响因素,将发生心脑血管事件的患者43例定义为发病组,未发生心脑血管事件的患者77例定义为未病组,Logistic回归分析显示CPAP治疗是OSAS患者心脑血管事件发生的保护因素(OR=0.225,P=0.000)。结论在接受基础疾病治疗的同时,采用CPAP治疗老年OSAS患者可以有效减少心脑血管事件发生的风险。
Objective To investigate the long-term effects of continuous positive airway pressure (CPAP) on cardiovascular and cerebrovascular events in elderly patients with obstructive sleep apnea syndrome (OSAS). Methods A total of 120 elderly patients with moderate to severe OSAS were selected. All patients were followed up regularly and their cardiovascular and cerebrovascular events were recorded. Meanwhile, the related factors of cardiovascular and cerebrovascular events in patients with OSAS were investigated. Results Among 120 elderly patients with moderate-to-severe OSAS, 39 patients who insisted CPAP were treated as experimental group; 81 patients who did not adhere to CPAP treatment were selected as control group. The incidence of cardiovascular and cerebrovascular events was 12.82% (5/39) in the experimental group and 46.91% (38/81) in the control group. The incidence of cardiovascular and cerebrovascular events in the experimental group was significantly lower than that in the control group (χ2 = 13.31, P <0.05). The Kaplan-Meier survival analysis showed that when the follow-up time was longer, the risk of cardiovascular and cerebrovascular events in the control group was significantly higher than that in the experimental group (χ2 = 16.5, P = 0.005). To analyze the influencing factors of cardiovascular and cerebrovascular events in patients with OSAS, 43 patients with cardiovascular and cerebrovascular events were defined as the incidence group, and 77 patients without cardiovascular events were defined as non-disease group. Logistic regression analysis showed that CPAP treatment was Protective factors of cardiovascular and cerebrovascular events in patients with OSAS (OR = 0.225, P = 0.000). CONCLUSIONS: In addition to the treatment of underlying diseases, CPAP treatment of elderly patients with OSAS can effectively reduce the risk of cardiovascular and cerebrovascular events.