CAJ | 학술논문

目的探计经鼻持续正压通气(nCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者心血管疾病危险因素的影响.方法将最新在呼吸睡眠监测中心确诊的中重度OSAHS患者31例,依据其使用呼吸机nCPAP时间的长短将其分为3组:组1(10例),>4 h/晚;组2(9例),<4 h/晚;组3(12例),拒绝使用呼吸机.分别在基础水平和6月后进行多导睡眠分析(PSG),全自动生化仪检测血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-I、载脂蛋白B,ELISA法检测外周血C-反应蛋白.结果 ①3组患者年龄、体重指数、血压、ESS评分以及血氧饱和度等比较差异均无统计学意义(P均>0.05);②组1、组2经过nCPAP治疗的OSAHS患者,其ESS评分、SPO_2、最低SPO_2较治疗前基线水平明显改善[(3.24±2.81)分与(13.3±5.2)分、(4.95±2.67)分与(12.8±5.5)分;(93.8±2.01)%与(88.6±4.14)%、(94.2±1.46)%与(89.1±5.11)%;(84.1±6.17)%与(69.6±11.77)%、(85.2±4.97)%与(73.7±12.5)%;P均<0.01];③组1经过nCPAP治疗后总胆固醇水平较前明显下降,差异有统计学意义(P=0.038);④经过nCPAP治疗后,组1、组2血清CRP水平较前均有下降,且组1治疗前后比较差异有统计学意义(P=0.021).结论依从性好的OSAHS患者经过nCPAP治疗后,能够显著降低心血管危险因素,这将为临床上心血管疾病危险因素的治疗提供新策略.
목적 탐계경비지속정압통기(nCPAP)대조새성수면호흡잠정저통기종합정(OSAHS)환자심혈관질병위험인소적영향.방법 장최신재호흡수면감측중심학진적중중도OSAHS환자31례,의거기사용호흡궤nCPAP시간적장단장기분위3조:조1(10례),>4 h/만;조2(9례),<4 h/만;조3(12례),거절사용호흡궤.분별재기출수평화6월후진행다도수면분석(PSG),전자동생화의검측혈청담고순(TC)、감유삼지(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、재지단백A-I、재지단백B,ELISA법검측외주혈C-반응단백.결과 ①3조환자년령、체중지수、혈압、ESS평분이급혈양포화도등비교차이균무통계학의의(P균>0.05);②조1、조2경과nCPAP치료적OSAHS환자,기ESS평분、SPO_2、최저SPO_2교치료전기선수평명현개선[(3.24±2.81)분여(13.3±5.2)분、(4.95±2.67)분여(12.8±5.5)분;(93.8±2.01)%여(88.6±4.14)%、(94.2±1.46)%여(89.1±5.11)%;(84.1±6.17)%여(69.6±11.77)%、(85.2±4.97)%여(73.7±12.5)%;P균<0.01];③조1경과nCPAP치료후총담고순수평교전명현하강,차이유통계학의의(P=0.038);④경과nCPAP치료후,조1、조2혈청CRP수평교전균유하강,차조1치료전후비교차이유통계학의의(P=0.021).결론 의종성호적OSAHS환자경과nCPAP치료후,능구현저강저심혈관위험인소,저장위림상상심혈관질병위험인소적치료제공신책략.
Objective To investigate the influence of nasal continuous positive airway pressure (nCPAP) treatment on cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea Syndrome (OSAHS). Methods Thirty-one patients with newly diagnosed OSAHS were divided into 3 groups based on the status of nC-PAP treatment: group 1,10 patients with nCPAP > 4 hrs/night;group 2:9 patients with nCPAP < 4 hrs/night;group 3:12 patients without nCPAP treatment. Serum cardiovascular risk factors (i. e. ,C-reactive protein(CRP), total cholesterol, triglycerides, highdensity lipaprntein cholesterol (HDL-C), low-density lipoprotein cholesterol, apo-lipoprotein A-I (ApoA-1), and apolipoprotein B (ApoB) ) were measured at baseline and 6 months after nCPAP treatment. Results ① There was no significant difference on age,body mass index,blcod pressure,Epworth sleepi-ness scale (ESS) and saturation of blood oxygen (SPO_2) between the 3 groups (P>0.05). ②In group 1, ESS, SPO_2 minimum SPO_2 were significantly improved (3.20±2.80,93.80±2.01 and 84.10±6.17, respectively) compared to baseline (13.30±5.20,88.60±4.14 and 69.60±11.80, respectively) (P<0.01). Moreover, in group 2, there were significant improvement on ESS, SPO_2 and minimum SPO2 (4.95±2.67,94.20±1.46 and 85.20±4.97, respectively) compared to baseline (12.80±5.50,89.10±5.11 and 73.70±12.50, respectively) (P<0.01). ③In group 1 ,significant decreases in the levels of CRP,total cholesterol was observed (P=0.021 and 0.038). ④In group 2, group 3 there were slightly decrease of CRP after treatment, but the difference did not reach statistieal significance. Conclusions Good compliance to nCPAP treatment decreases the serum levels of cardiovas-cular risk factors, indicating a beneficial effect on the overall cardiovascular disease prevention and control.