摘要
目的探讨不同甲状腺激素药物治疗甲状腺功能减退合并阻塞性睡眠呼吸暂停低通气综合征患者的临床效果。方法将66例甲状腺功能减退合并阻塞性睡眠呼吸暂停低通气综合征患者随机分为研究组和对照组,每组33例。所有患者均给予双水平无创正压通气治疗,对照组患者给予甲状腺片20mg,1次/日,之后依据患者的病情的严重程度每2个星期增加20mg,最大剂量为≤160mg。研究组患者给予左旋甲状腺素纳25μg,1次/日,再依据病情的严重程度每2个星期增加25μg剂量,最大剂量为≤200μg。比较两组患者的血清甲状腺激素水平和睡眠呼吸监测参数。结果治疗前两组患者甲状腺激素水平无统计学差异(P>0.05),治疗后研究组患者TSH、FT3、FT4水平均显著优于对照组(P<0.01)。治疗前两组患者睡眠呼吸参数无统计学差异(P>0.05),治疗后研究组患者AHI、睡眠时间、SpO2以及最大呼吸暂停时间均与对照组存在显著差异(P<0.05,P<0.01)。两组患者均无严重不良反应,且研究组不良反应发生率明显低于对照组(P<0.05)。结论应用左旋甲状腺素纳治疗甲状腺功能减退合并阻塞性睡眠呼吸暂停低通气综合征疗效显著、安全、无严重不良反应,具有较好临床应用价值。
Objective To investigate the effect of thyroid hormones on hypothyroidism complicated obstructive sleep hypopnea syndrome.Methods 66 hypothyroidism patients with obstructive sleep apnea hypopnea syndrome were randomly divided into study group and control group,33 cases in each group.All the patients were treated with noninvasive positive pressure ventilation in the treatment.The control group were treated with thyroid Tablets20mg/d,1 1times a day,then according to the severity of the condition of the patient every 2weeks increased to 20 mg,maximum dose must be less than or equal to 160 mg.Patients in study group were given sodium levothyroxine 25ug/d,11 times a day,according to the severity of the condition every 2weeks increased 25 g dose,but the maximum dose must be less than or equal to 200 mu G.Comparison of two groups of patients with serum thyroid hormone levels and sleep apnea monitoring parameters.Results Before treatment,two groups of thyroid hormone level in patients was no significantly different（P〈0.05）.After treatment,TSH,FT3,FT4 levels of the study group were significantly better than that of the control group（P〈0.01）.The sleep respiratory parameters of the two group before treatment were not significantly different（P〉0.05）.After treatment,AHI,SpO2 and the maximum sleep apnea time of the study group and the control group were significantly different（P〈0.05,P〈0.01）.The incidence of adverse reaction of the study group was lower than that of the control group（P〈0.05）.Conclusion It is safe and effective to treat hypothyroidism and obstructive sleep apnea hypopnea syndrome.
出处
《西部医学》
2015年第7期1034-1036,共3页
Medical Journal of West China
基金
四川省卫生厅科研课题(130429)
