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目的:观察鼾眠Ⅰ号联合持续正压通气治疗痰瘀互结型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的效果。方法:将64例痰瘀互结型OSAHS患者随机分为治疗组、对照组各32例。治疗组予鼾眠Ⅰ号联合持续正压通气治疗,对照组予持续正压通气治疗,2组疗程均为1月。观察治疗前后患者Epworth嗜睡量表(ESS)评分、呼吸暂停低通气指数(AHI)、呼吸紊乱指数(RDI)、最低血氧饱和度(LSa O2)以及血清C-反应蛋白(CRP)、白细胞介素-1(IL-1)、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)的变化。结果:治疗后,2组ESS评分均较治疗前下降,差异均有统计学意义(P<0.01,P<0.05);治疗组ESS评分低于对照组,差异有统计学意义(P<0.05)。2组AHI、RDI均较治疗前下降,差异均有统计学意义(P<0.01,P<0.05)。治疗组治疗前后LSa O2比较,差异有统计学意义(P<0.05),2组治疗后LSa O2比较,差异有统计学意义(P<0.05)。治疗组CRP、IL-1、IL-6、TNF-α均较治疗前下降,IL-10较治疗前上升,差异均有统计学意义(P<0.01,P<0.05);对照组CRP、IL-6、TNF-α均较治疗前下降,差异均有统计学意义(P<0.05);2组CRP、IL-6、TNF-α比较,差异均有统计学意义(P<0.01,P<0.05)。结论:鼾眠Ⅰ号联合持续正压通气治疗OSAHS可改善患者白天的嗜睡程度,减少夜间睡眠呼吸暂停、低通气次数,改善RDI,作用机制可能与降低血清炎症因子水平、减轻炎症反应相关。
Objective: To observe the effect of snoring sleep combined Ⅰ continuous positive pressure ventilation in patients with obstructive sleep apnea - hypopnea syndrome (OSAHS). Methods: 64 cases of phlegm and blood stasis type OSAHS patients were randomly divided into treatment group and control group, 32 cases each. The treatment group to snore sleep Ⅰ continuous positive pressure ventilation treatment, the control group was treated with continuous positive pressure ventilation, two groups of treatment were January. The Epworth Sleepiness Scale (ESS) score, AHI, RDI, LSa O2, and serum C-reactive protein (CRP) IL-1, IL-6, IL-10 and tumor necrosis factor-α (TNF-α) were measured. Results: After treatment, the ESS scores in both groups were significantly lower than those before treatment (P <0.01, P <0.05). The ESS score of the treatment group was lower than that of the control group (P <0.05) . The AHI and RDI in both groups were significantly lower than those before treatment (P <0.01, P <0.05). The difference of LSa O2 in the treatment group before and after treatment was statistically significant (P <0.05). The difference of LSa O2 between the two groups after treatment was statistically significant (P <0.05). The levels of CRP, IL-1, IL-6 and TNF-α in the treatment group decreased compared with those before treatment, and the levels of IL-10 in the treatment group increased significantly compared with those before treatment (P <0.01, (P <0.05). The levels of CRP, IL-6 and TNF-α in the two groups were significantly different (P <0.01, P < 0.05). Conclusion: The treatment of OSAHS by snoring sleep combined with continuous positive airway pressure can improve the degree of daytime sleepiness, reduce nighttime sleep apnea and hypopnea frequency, and improve RDI. The mechanism may be related to decreasing the level of serum inflammatory cytokines and reducing the inflammatory reaction.