无创机械通气治疗阻塞性睡眠呼吸暂停低通气综合征的疗效及对患者血清炎性因子的影响被引量：5

Effect of noninvasive mechanical ventilation in the treatment of obstructive sleep apnea hypopnea syndromeand its effect on serum inflammatory factors

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摘要目的探讨无创通气治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效以及对患者血清C反应蛋白（CRP）、内皮素－1（ET－1）及肿瘤坏死因子－α（TNF－α）的影响.方法选择2016年2月至2017年8月晋中市第一人民医院医院收治的86例中、重度OSAHS患者,根据治疗方法的不同分为观察组和对照组各43例.观察组采用无创通气治疗,对照组采用内科保守治疗.比较两组治疗前后PSG指标及炎性因子的差异,分析呼吸暂停低通气指数（AHI）、氧减指数（ODI）、最低血氧饱和度（LSpO2）、平均血氧饱和度（MSpO2）与CRP、ET－1、TNF－α的相关性.结果治疗后,两组AHI、ODI指数显著下降,LSpO2、MSpO2显著升高,且观察组AHI[（13.7 ±8.6）次/h比（43.1 ±13.6次/h]、ODI[（15.4 ±12.9）次/h比（42.5 ±12.6）次/h]、LSpO2 [（79.6 ±16.8）%比（62.3 ±19.27）%]、MSpO2[（92.2 ±25.6）%比（80.3 ±30.4）%]改善程度优于对照组,差异均有统计学意义（t＝5.291、4.258、3.998、4.651,均P＜0.05）.观察组治疗后CRP、ET－1、TNF－α均明显降低,对照组治疗前后上述指标改善差异无统计学意义;观察组治疗后CRP[（3.7 ±0.7） mg/L比（6.1 ± 1.8）mg/L]、ET－1[（32.3 ±11.9）ng/L比（46.5 ±16.6）ng/L]、TNF－α[（19.1 ±3.2）ng/L比（31.3 ±9.2）ng/L]水平明显低于对照组,差异均有统计学意义（t＝8.255、6.594、5.227,均P＜0.05）.经Pearson相关分析,AHI、ODI均与CRP、ET－1、TNF－α呈正相关（r＝0.33、0.56、0.44、0.26、0.55、0.63）,LSpO2、MSpO2则均与CRP、ET－1、TNF－α呈负相关（r＝－0.36、－0.44、－0.54、－0.28、－0.36、－0.59）.其中,ODI与TNF－α正相关系数最大,为0.63. MSpO2与TNF－α负相关系数最大,为－0.59.结论无创通气治疗OSAHS的疗效好,能够明显降低体内炎性因子水平. Objective To investigate the effect of non -invasive ventilator in the treatment of obstructive sleep apnea hypopnea syndrome （OSAHS） and the effect on C-reactive protein （CRP）,endothelin-1（ET-1） and tumor necrosis factor -alpha （TNF-α）.Methods From February 2016 to August 2017,86 patients with moderate and severe OSAHS in the First People＇s Hospital of Jinzhong were divided into the observation group and the control group according to the different treatment methods ,with 43 cases in each group.The observation group was treated with noninvasive ventilator ,and the control group was treated with conservative treatment .The differences of PSG and inflammatory factors were compared between the two groups before and after treatment ,and the correlation between AHI,ODI,LSpO2,MSpO2and CRP,ET-1,and TNF-αwas analyzed.Results After treatment,AHI,ODI,MSpO2 of the two groups were decreased significantly ,LSpO2increased significantly,and the AHI [（13.7 ±8.6）times/h vs. （43.1 ±13.6）times/h],ODI [（15.4 ±12.9）times/h vs.（42.5 ±12.6）times/h],LSpO2[（79.6 ±16.8）% vs. （62.3 ±19.27）%],MSpO2[（92.2 ±25.6）% vs.（80.3 ±30.4）%] in the observation group were better than those in the control group,the differences were statistically significant （t =5.291,4.258,3.998,4.651,all P〈0.05）.After treatment,the levels of CRP,ET-1,TNF -αin the observation group were decreased significantly , which in the control group had no statistically significant differences compared with those before treatment .After treat- ment,the CRP [（3.7 ±0.7）mg/L vs.（6.1 ±1.8）mg/L],ET-1 [（32.3 ±11.9）ng/L vs.（46.5 ±16.6）ng/L], TNF-α[（19.1 ±3.2）ng/L vs.（31.3 ±9.2）ng/L] in the observation group were significantly lower than those in the control group,the difference were statistically significant （t=8.255,6.594,5.227,all P〈0.05）.After Pearson correlation analysis,AHI and ODI were positively correlated with CRP,ET-1 and TNF-α（r=0.33,0.56,0.44, 0.26,0.55,0.63）,while LSpO2and MSpO2were negatively correlated with CRP,ET-1,TNF-α（r=-0.36,-0.44,-0.54,-0.28,-0.36,-0.59）.Among them,the positive correlation coefficient of ODI and TNF -αwas the largest（0.63）.The negative correlation coefficient of MSpO2 and TNF-was the largest（-0.59）.Conclusion Non-invasive ventilator in the treatment of OSAHS is effective and can obviously reduce the level of inflammatory factors in the body.

作者李静武瑞芳 Li Jing;Wu Ruifang(Department of Respiratory Diseases,the First People＇s Hospital of Jinzhong,Jinzhong,Shanxi 030600,China)

机构地区晋中市第一人民医院呼吸科

出处《中国基层医药》 CAS 2018年第20期2638-2641,共4页 Chinese Journal of Primary Medicine and Pharmacy

关键词睡眠呼吸暂停阻塞性无创性通气 C反应蛋白质内皮素-1 肿瘤坏死因子Α Sleep apnea obsteuctive Noninvasive ventilator C - reactive protein Endothelin-1 Tumor necrosis factor-alpha

分类号 R766 [医药卫生—耳鼻咽喉科]

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1水跃翔,童海燕,赵顺金,鲍绪新,杨惠芳,滕丽仙,杨婷,祝茂仙,吴杨,吴晓红.不同无创通气模式对阻塞性睡眠呼吸暂停低通气综合征患者心脏结构和功能的影响[J].中国基层医药,2016,23(13):1970-1974. 被引量：8

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