国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
5期
348-351
,共4页
黄蓉%钟旭%肖毅%黄席珍
黃蓉%鐘旭%肖毅%黃席珍
황용%종욱%초의%황석진
阻塞性睡眠呼吸暂停低通气综合征%持续气道内正压%自动调节气道内正压%自动压力滴定
阻塞性睡眠呼吸暫停低通氣綜閤徵%持續氣道內正壓%自動調節氣道內正壓%自動壓力滴定
조새성수면호흡잠정저통기종합정%지속기도내정압%자동조절기도내정압%자동압력적정
Obstructive sleep apnea hypopnea syndrome%Continuous positive airway pressure%Autotitrating positive airway pressure%Automatic titration
目的 评价自动压力滴定推荐的经鼻持续气道内正压通气(nasal continuous positive airway pressure,nCPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的长期有效性和顺应性.方法 36例中重度OSAHS患者在睡眠呼吸实验室进行一夜自动压力滴定治疗,记录并对比治疗前后的呼吸暂停低通气指数(apnea hypopnea index,AHI)和最低血氧饱和度(lowest oxygen satuation,LSO2).其中16例OSAHS患者选用自动压力滴定的95％可信限压力(P95)作为nCPAP家庭治疗值,并在治疗6个月后返实验室再次评估P95的长期治疗效果、依从性和患者的嗜睡症状.结果 一夜自动压力滴定后,36例OSAHS的AHI[(63.83±4.79)次/h vs(4.55±0.67)次/h,P〈0.001]显著降低,LSO2[(65.39±1.99)％ vs(91.17±0.70)％,P＜0.001]显著升高；16例选用P95长期家庭CPAP治疗者,平均每日治疗时间(6.63±0.25)h,随诊6个月后评估,P95仍有明显疗效[AHI:(75.98±5.77)次/h vs (4.91±1.15)次/h,P＜0.001; LSO2:(62.00±2.52)％ vs (94.44±0.70)％,P＜0.001];Epworth嗜睡量表评分显著降低(16.75±0.87 vs 4.88±0.36,P=0.001).结论 自动调节气道内正压治疗能有效纠正OSAHS的呼吸紊乱和低氧.自动压力滴定所推荐的P95作为家庭CPAP的长期治疗压在第6个月随访时仍是有效的,能改善嗜睡,并有较高的依从性,可用于nCPAP长期治疗的压力设定.
目的 評價自動壓力滴定推薦的經鼻持續氣道內正壓通氣(nasal continuous positive airway pressure,nCPAP)治療阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea hypopnea syndrome,OSAHS)的長期有效性和順應性.方法 36例中重度OSAHS患者在睡眠呼吸實驗室進行一夜自動壓力滴定治療,記錄併對比治療前後的呼吸暫停低通氣指數(apnea hypopnea index,AHI)和最低血氧飽和度(lowest oxygen satuation,LSO2).其中16例OSAHS患者選用自動壓力滴定的95％可信限壓力(P95)作為nCPAP傢庭治療值,併在治療6箇月後返實驗室再次評估P95的長期治療效果、依從性和患者的嗜睡癥狀.結果 一夜自動壓力滴定後,36例OSAHS的AHI[(63.83±4.79)次/h vs(4.55±0.67)次/h,P〈0.001]顯著降低,LSO2[(65.39±1.99)％ vs(91.17±0.70)％,P＜0.001]顯著升高；16例選用P95長期傢庭CPAP治療者,平均每日治療時間(6.63±0.25)h,隨診6箇月後評估,P95仍有明顯療效[AHI:(75.98±5.77)次/h vs (4.91±1.15)次/h,P＜0.001; LSO2:(62.00±2.52)％ vs (94.44±0.70)％,P＜0.001];Epworth嗜睡量錶評分顯著降低(16.75±0.87 vs 4.88±0.36,P=0.001).結論 自動調節氣道內正壓治療能有效糾正OSAHS的呼吸紊亂和低氧.自動壓力滴定所推薦的P95作為傢庭CPAP的長期治療壓在第6箇月隨訪時仍是有效的,能改善嗜睡,併有較高的依從性,可用于nCPAP長期治療的壓力設定.
목적 평개자동압력적정추천적경비지속기도내정압통기(nasal continuous positive airway pressure,nCPAP)치료조새성수면호흡잠정저통기종합정(obstructive sleep apnea hypopnea syndrome,OSAHS)적장기유효성화순응성.방법 36례중중도OSAHS환자재수면호흡실험실진행일야자동압력적정치료,기록병대비치료전후적호흡잠정저통기지수(apnea hypopnea index,AHI)화최저혈양포화도(lowest oxygen satuation,LSO2).기중16례OSAHS환자선용자동압력적정적95％가신한압력(P95)작위nCPAP가정치료치,병재치료6개월후반실험실재차평고P95적장기치료효과、의종성화환자적기수증상.결과 일야자동압력적정후,36례OSAHS적AHI[(63.83±4.79)차/h vs(4.55±0.67)차/h,P〈0.001]현저강저,LSO2[(65.39±1.99)％ vs(91.17±0.70)％,P＜0.001]현저승고；16례선용P95장기가정CPAP치료자,평균매일치료시간(6.63±0.25)h,수진6개월후평고,P95잉유명현료효[AHI:(75.98±5.77)차/h vs (4.91±1.15)차/h,P＜0.001; LSO2:(62.00±2.52)％ vs (94.44±0.70)％,P＜0.001];Epworth기수량표평분현저강저(16.75±0.87 vs 4.88±0.36,P=0.001).결론 자동조절기도내정압치료능유효규정OSAHS적호흡문란화저양.자동압력적정소추천적P95작위가정CPAP적장기치료압재제6개월수방시잉시유효적,능개선기수,병유교고적의종성,가용우nCPAP장기치료적압력설정.
Objective To evaluate automatic titration for the determination of therapeutic nasal continuous positive airway pressure (nCPAP) in obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Thirty-six previously untreated OSAHS patients had undergone one night automatic titration in the laboratory.Apnea hypopnea index(AHI) and lowest oxygen satuation(LSO2) were measured before and after the automatic titration.The 95th percentile airway pressure (P95)of the automatic titration was recommended as the long-term fixed CPAP therapeutic pressure.Only sixteen regular nCPAP treatment subjects whose body weights were stable(BMI≤l.5 kg/m2 change from baseline) were recruited to the reassessment study after 6 months of treatment with nCPAP at P95.This evaluation was based on compliance,daily usage,Epworth sleepiness score and respiratory recording under nCPAP.Results After one overnight automatic titration,there was a significant decrease in AHI (63.83±4.79 events/h vs 4.55 ± 0.67 events/h,P 〈0.001) and increase in LSO2 [(65.39 ± 1.99) ％ vs (91.17 ± 0.70) ％,P ＜0.001].And after 6 months of fixed nCPAP treatment,the reassessment study showed the recommended 95th percentile airway pressure by automatic titration was continued to valid to treat the OSAHS [n =16,AHI:before,75.98±5.77/h,after,4.91±1.15/h,P 〈0.001.LSO2:before,(62.00±2.52)％,after,(94.44±0.70)％,P 〈0.001].The Epworth sleepiness scale was significantly decreased (before,16.75±0.87,after,4.88±0.36,P =0.001).The daily usage was (6.63±0.25) h.Conclusions This study confirms the efficacy of automatic titration and the suitability of P95 determined by automatic titration after 6 months.The P95 can be applied for the long-term fixed single therapeutic pressure in OSAHS.
