摘要
目的观察双水平正压(BiPAP)无创通气治疗慢性阻塞性肺疾病(COPD)患者夜间低氧血症效果。方法用多睡眠监测仪筛选出稳定期COPD夜间低氧患者82例,夜间睡眠用双水平正压无创通气治疗14天,第14天夜间用多睡眠监测仪再次进行睡眠监测。比较治疗前后的夜间血氧情况、睡眠结构变化。同时分别检测患者治疗前1天和治疗第14天的血清白细胞介素6(IL-6)情况。结果稳定期COPD夜间低氧患者夜间睡眠用无创通气治疗后,其平均血氧饱和度(SaO2)治疗前为(85.01±5.61)%vs第14天(92.12±6.81)%和最低SaO2治疗前为(65.23±6.91)%vs第14天(87.02±7.64)%明显增加,SaO2低于90%占睡眠总时间(T90)治疗前为(50.13±8.11)%vs第14天为(10.24±4.11)%明显减低。睡眠结构恢复正常。血清IL-6从治疗前(34.21±4.62)ng/L,治疗第14天减少为(18.60±6.42)ng/L(P<0.01)。结论无创通气是治疗COPD稳定期患者夜间低氧血症的有效方法。
Objective To observe the effect of bi level positive airway pressure（BiPAP） therapy on nocturnal hypoxemia in patients with chronic obstructive pulmonary disease （COPD）. Methods Eighty-two COPD patients proved to be nocturnal hypoxemia in stable stage by polysomnogram（PSG） for 7 hours at night. After 14 days BiPAP therapy,patients were monitored by PSG at leith night in BiPAP therapy again, and compared on nocturnal hypoxemia and sleep structures before BiPAP therapy and 14th night BiPAP therapy. Blood serum IL-6 of 82 patients was measured by ELISA before and after BiPAP therapy. Results Under BiPAP therapy, 82 patients showed favorable response in elevation of the average values of mean nocturnal SaO2 （MNSaO2）（ P %0.01）,nocturnal minimal SaO2 （ P 〈0.01 ） and decrease of T90 （ P 〈0. 01） in contrast to the values obtained when they breathed in air through whole night. After BiPAP therapy,their sleep structures recovered as usual. Before BiPAP therapy, MNSaO2 was （85.01 ± 5.61） 0.40, before BiPAP therapy minimal SaO2 （65.23 ± 6.91 ） ~ and after BiPAP therapy minimal SaO2 （87.02 ±7.64） M, before BiPAP therapy T90 was （50.13±8.11）% and after BiPAP therapy T90, （10. 24±4.11） % and BiPAP therapy MNSaO2 （92.12±6.81） %. The level of blood serum IL-6 was （34.21±4.62） ng/L in the patients with nocturnal oxygen before BiPAP therapy, （18.60 ± 6.42） ng/L in the patients after BiPAP therapy. Conclusion BiPAP therapy is an effective way in treating nocturnal hypoxemia in stable COPD patients.
出处
《临床荟萃》
CAS
2010年第4期284-286,共3页
Clinical Focus
基金
合肥市科技局课题(合科[2006]46号-58)
关键词
肺疾病
慢性阻塞性
低氧血症
呼吸
人工
pulmonary disease, chronic obstructive
anoxemia
respiration, artificial
