CAJ | 학술논문

目的探讨自动调节持续气道正压通气(auto-CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼出气冷凝液(EBC)和血清中瘦素水平的影响.方法根据多导睡眠监测确诊的42例中重度OSAHS患者,随机分为治疗组22例和对照组20例,对治疗组进行三个月auto-CPAP治疗,对治疗组和对照组患者均采取常规治疗,分别测定治疗组及对照组三个月前后EBC和血清中的瘦素.结果 ①治疗组患者EBC和血清中瘦素治疗前[(5.67±1.07) μg/L、(40.20±5.40)μg/L]高于治疗后[(3.75±1.09)μg/L、(30.46±5.82)μg/L](P＜0.01);②对照组患者EBC和血清中Lep治疗前为[(5.52±1.14) μg/L、(42.19±4.96) μg/L],治疗后为[(5.95±1.26) μg/L、(42.69±4.33)μg/L],治疗前后差异无统计学意义(P＞0.05)；③OSAHS患者EBC和血清中瘦素水平与呼吸暂停低通气指数呈正相关(r=0.787,P＜0.01; r=0.775,P＜0.01),与最低血氧饱和度、平均血氧饱和度呈负相关(r=-0.829,P＜0.01;r=0.794,P＜0.01)、(r=-0.890,P＜0.01;r=-0.830,P＜0.01).结论 OSAHS患者存在高瘦素血症,auto-CPAP治疗可以改善OSAHS患者的高瘦素血症.
목적 탐토자동조절지속기도정압통기(auto-CPAP)치료대조새성수면호흡잠정저통기종합정(OSAHS)환자호출기냉응액(EBC)화혈청중수소수평적영향.방법 근거다도수면감측학진적42례중중도OSAHS환자,수궤분위치료조22례화대조조20례,대치료조진행삼개월auto-CPAP치료,대치료조화대조조환자균채취상규치료,분별측정치료조급대조조삼개월전후EBC화혈청중적수소.결과 ①치료조환자EBC화혈청중수소치료전[(5.67±1.07) μg/L、(40.20±5.40)μg/L]고우치료후[(3.75±1.09)μg/L、(30.46±5.82)μg/L](P＜0.01);②대조조환자EBC화혈청중Lep치료전위[(5.52±1.14) μg/L、(42.19±4.96) μg/L],치료후위[(5.95±1.26) μg/L、(42.69±4.33)μg/L],치료전후차이무통계학의의(P＞0.05)；③OSAHS환자EBC화혈청중수소수평여호흡잠정저통기지수정정상관(r=0.787,P＜0.01; r=0.775,P＜0.01),여최저혈양포화도、평균혈양포화도정부상관(r=-0.829,P＜0.01;r=0.794,P＜0.01)、(r=-0.890,P＜0.01;r=-0.830,P＜0.01).결론 OSAHS환자존재고수소혈증,auto-CPAP치료가이개선OSAHS환자적고수소혈증.
Objective To investigate the effect of auto-CPAP therapy on the concentrations of leptin in exhaled breath condensate and plasma in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods 42 patients with moderate-to-severe OSAHS diagnosed by polysomnograpgy monitoring were randomly allocated to the active group (n =22) or the control group (n =20) respectively.The active group received the treatment of three months' auto-CPAP and all of the subjects received general treatment.Leptin levels in EBC and plasma were measured by enzyme linked immunosorbent assay (ELISA) before and after 3 months.Results ①The concentrations of leptin in EBC and plasma in the active group before treatment [(5.67± 1.07) μg/L,(40.20 ± 5.40) μg/L] were higher than the after [(3.75 ± 1.09) μg/L,(30.46 ± 5.82) μg/L].②The concentrations of leptin in EBC and plasma in the control group before treatment were[(5.52 ±1.14) μg/L,(42.19±4.96) μg/L] and were [(5.95± 1.26) μg/L,(42.69 ± 4.33) μg/L] after the treatment.But there was no statistical difference tetween the before and after the treatment.③Leptin levels in plasma and EBC were positively related with apnea hypoventilation index(AHI),and were inversely related with the lowest blood oxygen saturatin (r =-0.829,P＜0.01.r =0.794,P ＜0.01)and average blood oxygen saturation (r=-0.890,P＜0.01.r =-0.830,P ＜0.01).Conclusions The hyperleptinemia in OSAHS patients and can be improved by auto-CPAP treatment.