摘要
目的:探讨经鼻持续气道正压通气(nCPAP)联合抗反流药物治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴胃食管反流(GER)的疗效。方法:对60例中重度OSAHS伴GER的患者行PSG和24h食管pH同步监测后,随机分为两组,每组30例。对照组每晚给予nCPAP治疗;治疗组在对照组每晚nCPAP治疗基础上联合口服埃索美拉唑40mg/d,枸橼酸莫沙必利5mg,3次/d。两组均于治疗第3、14天观察OSAHS症状及GER症状的改善情况,并于第14天晚重复PSG和24h食管pH同步监测。结果:与对照组相比,治疗组治疗第3天的OSAHS症状改善率及GER症状改善率差异有统计学意义(P<0.05),治疗第14天的OSAHS症状改善率及GER症状改善率均无明显提高,差异无统计学意义(P>0.05);治疗组第14天所测得的AHI、LSaO2、pH<4时间百分比、最长反流时间、反流次数及DeMeester评分与对照组比较差异均无统计学意义(P>0.05)。结论:nCPAP是治疗OSAHS伴GER的有效方法,联合使用抗反流药物并不能提高疗效。
Objective：To investigate the therapeutic effect of nasal continuous positive airways pressure（nCPAP） combined with antireflux medicine on obstructive sleep apnea hypopnea syndrome（OSAHS） with gastroesophageal reflux（GER）.Method：Sixty patients with moderate to severe OSAHS with GER were simultaneously received PSG and esophageal pH monitoring and randomly divided into control group and treatment group with each group 30 patients.The control group were simply received nCPAP for every night.The treatment group were received the same treatment and combined antireflux medicine,with esomeprazole 40 mg/d and mosapride citrate 5 mg,3 times a day,oral.Both the groups symptomatic status of OSAHS and GER were observed on the third day and the 14th day during therapy,and then the same tests above were repeated on the 14th day.Result：Compared with the control group,the symptomatic improvement rate of OSAHS on the third day and 14th day during therapy,the symptomatic improvement rate of GER on the third day during therapy were increased with statistical significance in the treatment group（P〈0.05）,however,the difference of symptomatic improvement rate of GER between the two groups on the 14th day during therapy did not have statistical significance（P〈0.05）.Compared with those of the control group on the 14th therapeutic night,AHI,LSaO2,the percentage of time with pH 4,the longest reflux duration,reflux episodes and DeMeester scoring did not have statistical significance in the treatment group（P〈0.05）.Conclusion：nCPAP is the most effective method for patients suffering OSAHS associated with GER,but nCPAP used in conjunction with anti-reflux drugs do not improve efficacy.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2013年第12期659-661,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
