天津医科大学学报
天津醫科大學學報
천진의과대학학보
Journal of Tianjin Medical University
2015年
5期
412-417
,共6页
阻塞性睡眠呼吸障碍低通气综合征%持续气道正压通气%口腔矫治器%体育锻炼
阻塞性睡眠呼吸障礙低通氣綜閤徵%持續氣道正壓通氣%口腔矯治器%體育鍛煉
조새성수면호흡장애저통기종합정%지속기도정압통기%구강교치기%체육단련
obstructive sleep apnea hypopnea syndrome%continuous positive airway pressure%oral appliance%exercise training
目的:对比分析持续气道正压通气(CPAP)、 口腔矫治器(OA) 和体育锻炼治疗阻塞性睡眠呼吸障碍低通气综合征(OSAHS)的疗效差别. 方法:根据纳入/排除标准,选取OSAHS患者63例,随机分成CPAP治疗组(n=19)、OA治疗组(n=21)和体育锻炼组(n=23)等3组,分别给予3个月的CPAP治疗、OA治疗或体育锻炼.对比分析患者治疗前后的多导睡眠图(PSG)监测结果,血液学指标检查和日间嗜睡评分量表(ESS)等的变化. 结果:相比治疗前,CPAP组和OA组治疗3个月后的呼吸暂停低通气指数(AHI)明显降低(P<0.01),睡眠潜伏期缩短(P<0.05),觉醒时间缩短(P<0.05),微觉醒指数均降低(P<0.05),睡眠平均SpO2提高(P<0.05). 体育锻炼组患者锻炼后与锻炼前相比,ESS评分降低(P<0.05),其他指标锻炼前后的差异无统计学意义(P均>0.05). 但体育锻炼组患者血液相关指标变化明显,主要是白细胞降低,胆固醇降低,极低密度脂蛋白降低,甘油三酯降低等(P均<0.05).结论:持续气道正压通气和口腔矫治器均可以降低呼吸暂停低通气指数等睡眠指标;体育锻炼仅能改善OSAHS患者的白日嗜睡症状和一些血液学指标,单独疗效不明显.
目的:對比分析持續氣道正壓通氣(CPAP)、 口腔矯治器(OA) 和體育鍛煉治療阻塞性睡眠呼吸障礙低通氣綜閤徵(OSAHS)的療效差彆. 方法:根據納入/排除標準,選取OSAHS患者63例,隨機分成CPAP治療組(n=19)、OA治療組(n=21)和體育鍛煉組(n=23)等3組,分彆給予3箇月的CPAP治療、OA治療或體育鍛煉.對比分析患者治療前後的多導睡眠圖(PSG)鑑測結果,血液學指標檢查和日間嗜睡評分量錶(ESS)等的變化. 結果:相比治療前,CPAP組和OA組治療3箇月後的呼吸暫停低通氣指數(AHI)明顯降低(P<0.01),睡眠潛伏期縮短(P<0.05),覺醒時間縮短(P<0.05),微覺醒指數均降低(P<0.05),睡眠平均SpO2提高(P<0.05). 體育鍛煉組患者鍛煉後與鍛煉前相比,ESS評分降低(P<0.05),其他指標鍛煉前後的差異無統計學意義(P均>0.05). 但體育鍛煉組患者血液相關指標變化明顯,主要是白細胞降低,膽固醇降低,極低密度脂蛋白降低,甘油三酯降低等(P均<0.05).結論:持續氣道正壓通氣和口腔矯治器均可以降低呼吸暫停低通氣指數等睡眠指標;體育鍛煉僅能改善OSAHS患者的白日嗜睡癥狀和一些血液學指標,單獨療效不明顯.
목적:대비분석지속기도정압통기(CPAP)、 구강교치기(OA) 화체육단련치료조새성수면호흡장애저통기종합정(OSAHS)적료효차별. 방법:근거납입/배제표준,선취OSAHS환자63례,수궤분성CPAP치료조(n=19)、OA치료조(n=21)화체육단련조(n=23)등3조,분별급여3개월적CPAP치료、OA치료혹체육단련.대비분석환자치료전후적다도수면도(PSG)감측결과,혈액학지표검사화일간기수평분량표(ESS)등적변화. 결과:상비치료전,CPAP조화OA조치료3개월후적호흡잠정저통기지수(AHI)명현강저(P<0.01),수면잠복기축단(P<0.05),각성시간축단(P<0.05),미각성지수균강저(P<0.05),수면평균SpO2제고(P<0.05). 체육단련조환자단련후여단련전상비,ESS평분강저(P<0.05),기타지표단련전후적차이무통계학의의(P균>0.05). 단체육단련조환자혈액상관지표변화명현,주요시백세포강저,담고순강저,겁저밀도지단백강저,감유삼지강저등(P균<0.05).결론:지속기도정압통기화구강교치기균가이강저호흡잠정저통기지수등수면지표;체육단련부능개선OSAHS환자적백일기수증상화일사혈액학지표,단독료효불명현.
Objective:To compare the effects of continuous positive airway pressure (CPAP), oral appliance (OA) and exercise training for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods:Sixty-three patients with OSAHS and body mass indices less than 28 kg/m2 were randomly divided into 3 groups:CPAP (n=19), OA (n=21) and exercise training (n=23). Polysomnography (PSG), blood samples and Epworth sleepiness scale (ESS) were obtained before and after 3 months of physical exercise or treatment with CPAP or OA. Results:After treatment with CPAP or an OA, the patients were presented with reductions in the apnea-hypopnea index (AHI), sleep latency, awakening time and arousal index, and increase in the average sleep SpO2. No changes in the sleep parameters were observed in the physical exercise group. However, this group was presented with reductions in the following parameters:white blood cell, cholesterol, very-low-density lipoprotein and triglycerides. Three months of exercise and training was found to have a positive efficacy on subjective daytime sleepiness of ESS. Conclusion:CPAP and OA can reduce some sleepy indicators, such as apnea hypopnea index. Physical exercise and training, if achieved, could improve somnolence and blood indicators of the patients, but physical training alone is not sufficiently effective.
