摘要
目的通过全夜多导睡眠图（ＰＳＧ）有关呼吸紊乱和低氧血症的指标，预测阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）患者所需的经鼻罩持续性气道内正压通气（ＣＰＡＰ）的最佳压力水平（Ｐｍ），并用于指导临床应用。方法采用ＲＨＫ－５５００型多导睡眠监测系统联接ＢｉＰＡＰ（ＳＴ／Ｄ）系统测定１８例ＯＳＡＳ患者经鼻罩ＣＰＡＰ的Ｐｍ，并推导其与呼吸紊乱指数（ＲＤＩ）或血氧饱和度低于９０％时间（ＴＳ９０）的回归方程。采用此回归方程预测Ｐｍ，并对６例（预测组）ＯＳＡＳ患者进行１周治疗（每夜８～１０小时），其结果与采用实测Ｐｍ进行ＣＰＡＰ治疗的１３例（实测组）ＯＳＡＳ患者（同样疗程）相对比。所有患者在治疗前和治疗后１～２天测定ＰＳＧ。结果ＲＤＩ或ＴＳ９０与Ｐｍ呈显著的直线正相关；用预测Ｐｍ治疗ＯＳＡＳ，其症状及ＰＳＧ指标均有显著改善，疗效与用实测Ｐｍ组者差异无显著性。
ObjectiveTopredictanoptimallevelofcontinuouspositiveairwaypressure(CPAP)inthemenagementofobstructivesleepapneasyndrome(OSAS)ome(OSAS)byrelatingcertainparametersofrespira-torydisturbanceandsleephypoxemia.Metosd18patientswithOSAS(almale,aged48±11yrs)wereenroledinthestudy.TheiractuallevelsofCPAP(Pm)weredeterminedbyaRHK-5500mode-polysomnographicsystemplusBiPAP(ST/D)system.TheactualPmwasrelatedtotherespiratorydis-turbanceindex(RDI)ortotaltimeofSaO2≤90%(TS90).Thecorrelationregressionequationswerecal-culated.6patientswithOSAS(GroupA)weretreatedwiththepredictednasalCPAP(predictedPm)whichwasderivedfromtheregressionequation,8～10hourspernight,for5～7nights.13pa-tients(GroupB)receivingnasalCPAPtreatmentusingtheactualymeassuredPmservedascontrol.ResultsTherewasaclosepositivelinearcorelationbetweenRDIorTS90andactualPm.SymptomsandpolysomnographicparametersimprovedsignificantlyafteronecourseofCPAPtreatmentinGroupA.TheeficacyshowednosignificantdiferenceascomparedwiththatinGroupB.ConclusionsItwassug-gestedthatRDIorTS90areofvalueandsimpleinpredictingthepressurelevelofCPAPinthemanage-mentofOSASwithnasalCPAP.
出处
《中华结核和呼吸杂志》
CSCD
北大核心
1996年第5期269-272,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
