中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2010年
8期
532-535
,共4页
睡眠呼吸暂停,阻塞性%连续气道正压通气%哮喘%生活质量
睡眠呼吸暫停,阻塞性%連續氣道正壓通氣%哮喘%生活質量
수면호흡잠정,조새성%련속기도정압통기%효천%생활질량
Sleep apnea,obstructive%Continuous positive airway pressure%asthma%Quality of life
目的 观察夜间持续气道正压通气对伴有哮喘的阻塞性睡眠呼吸暂停综合征(OSAS)患者的肺功能、哮喘发作次数及生存质量的影响.方法 以胃食管反流评分量表≥12分为标准,将处在慢性持续期哮喘的中重度男性OSAS患者23例分为两组,胃食管反流(GER)组(9例)和非GER组(14例).分别于治疗前行整夜多导睡眠监测(PSG),完成肺功能测定及填写嗜睡评分(ESS)、睡眠呼吸暂停生存质量调查表(QOLAp)和哮喘生存质量调查表(QOLAs).然后进行为期4周的持续气道正压通气,并再次进行肺功能测定及各评分表的填写.结果 治疗4周后,两组患者肺功能较治疗前无明显改善,但QOLAp、ESS评分、QOLAs在治疗前后差异有统计学意义,GER组分别为(12.8±2.8)分与(4.6±0.9)分、(5.1±0.7)分与(6.3±0.6)分、(4.1±0.5)分与(6.3±0.5)分;非GER组分别为(13.0±2.9)分与(4.6±1.1)分、(4.7±0.5)分与(5.6±0.6)分、(3.6±0.3)分与(5.8±0.6)分,P＜0.01或0.05.经治疗后哮喘发作次数及夜间哮喘发作次数在GER组有明显减少,分别由(2.9±2.0)次/周、(1.4±0.8)次/周减少为(1.7±1.1)次/周和(0.7±0.3)次/周,而在非GER组并无显著降低.治疗后GER组QOLAs的改善较非GER组更为明显(P＜0.05).结论 夜间持续气道正压通气虽然没有改变受试者的肺功能,却显著提高了哮喘患者的生存质量,特别是有GER症状并伴有哮喘的OSAS患者.
目的 觀察夜間持續氣道正壓通氣對伴有哮喘的阻塞性睡眠呼吸暫停綜閤徵(OSAS)患者的肺功能、哮喘髮作次數及生存質量的影響.方法 以胃食管反流評分量錶≥12分為標準,將處在慢性持續期哮喘的中重度男性OSAS患者23例分為兩組,胃食管反流(GER)組(9例)和非GER組(14例).分彆于治療前行整夜多導睡眠鑑測(PSG),完成肺功能測定及填寫嗜睡評分(ESS)、睡眠呼吸暫停生存質量調查錶(QOLAp)和哮喘生存質量調查錶(QOLAs).然後進行為期4週的持續氣道正壓通氣,併再次進行肺功能測定及各評分錶的填寫.結果 治療4週後,兩組患者肺功能較治療前無明顯改善,但QOLAp、ESS評分、QOLAs在治療前後差異有統計學意義,GER組分彆為(12.8±2.8)分與(4.6±0.9)分、(5.1±0.7)分與(6.3±0.6)分、(4.1±0.5)分與(6.3±0.5)分;非GER組分彆為(13.0±2.9)分與(4.6±1.1)分、(4.7±0.5)分與(5.6±0.6)分、(3.6±0.3)分與(5.8±0.6)分,P＜0.01或0.05.經治療後哮喘髮作次數及夜間哮喘髮作次數在GER組有明顯減少,分彆由(2.9±2.0)次/週、(1.4±0.8)次/週減少為(1.7±1.1)次/週和(0.7±0.3)次/週,而在非GER組併無顯著降低.治療後GER組QOLAs的改善較非GER組更為明顯(P＜0.05).結論 夜間持續氣道正壓通氣雖然沒有改變受試者的肺功能,卻顯著提高瞭哮喘患者的生存質量,特彆是有GER癥狀併伴有哮喘的OSAS患者.
목적 관찰야간지속기도정압통기대반유효천적조새성수면호흡잠정종합정(OSAS)환자적폐공능、효천발작차수급생존질량적영향.방법 이위식관반류평분량표≥12분위표준,장처재만성지속기효천적중중도남성OSAS환자23례분위량조,위식관반류(GER)조(9례)화비GER조(14례).분별우치료전행정야다도수면감측(PSG),완성폐공능측정급전사기수평분(ESS)、수면호흡잠정생존질량조사표(QOLAp)화효천생존질량조사표(QOLAs).연후진행위기4주적지속기도정압통기,병재차진행폐공능측정급각평분표적전사.결과 치료4주후,량조환자폐공능교치료전무명현개선,단QOLAp、ESS평분、QOLAs재치료전후차이유통계학의의,GER조분별위(12.8±2.8)분여(4.6±0.9)분、(5.1±0.7)분여(6.3±0.6)분、(4.1±0.5)분여(6.3±0.5)분;비GER조분별위(13.0±2.9)분여(4.6±1.1)분、(4.7±0.5)분여(5.6±0.6)분、(3.6±0.3)분여(5.8±0.6)분,P＜0.01혹0.05.경치료후효천발작차수급야간효천발작차수재GER조유명현감소,분별유(2.9±2.0)차/주、(1.4±0.8)차/주감소위(1.7±1.1)차/주화(0.7±0.3)차/주,이재비GER조병무현저강저.치료후GER조QOLAs적개선교비GER조경위명현(P＜0.05).결론 야간지속기도정압통기수연몰유개변수시자적폐공능,각현저제고료효천환자적생존질량,특별시유GER증상병반유효천적OSAS환자.
Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P＜0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P ＜ 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P ＜ 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.
