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目的:探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)在持续无创正压通气(CPAP)治疗前后微觉醒的变化。方法:随机选择20例OSAHS患者CPAP治疗前和治疗中多导睡眠呼吸监测(poly somnography,PSG)结果,据此分别计算CPAP治疗前后的呼吸紊乱指数(AHI)、氧减指数,以及与呼吸相关微觉醒次数,与呼吸无关的微觉醒次数、总的微觉醒次数、微觉醒指数,并且通过t检验进行比较分析。结果:经CPAP治疗,20例患者与呼吸相关微觉醒次数、总的微觉醒次数、微觉醒指数、AHI、氧减指数均有明显降低(P<0.001)。与呼吸无关的微觉醒次数也有降低(P<0.034)。呼吸相关微觉醒次数、氧减指数、总的微觉醒次数、微觉醒指数、与呼吸无关的微觉醒次数与AHI均呈正相关(P<0.01)。AHI微觉醒指数、呼吸相关微觉醒次数、总的微觉醒次数与氧减指数均呈正相关(P<0.01或P<0.05)。呼吸无关的微醒次数与氧减指数无相关性(r=0.59,P=0.012)。结论:OSAHS患者经CPAP治疗后与呼吸相关微觉醒次数、总的微觉醒次数、微觉醒指数、AHI、氧减指数有明显下降,呼吸暂停基本消失,与呼吸无关的微觉醒次数有下降但不明显。CPAP为治疗OSAHS的有效的方法。
Objective: To investigate the changes of arousal before and after continuous noninvasive positive pressure ventilation (CPAP) in obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: Twenty patients with OSAHS were randomly selected before and after CPAP treatment, and polysomnography (PSG) results were obtained. Respiratory disturbance index (AHI), oxygen reduction index (CPI) and respiratory depression The number of arousals, the number of arousals unrelated to breathing, the total number of arousals, the arousal index, and comparative analysis by t-test. Results: After CPAP treatment, the number of respiration-related arousals, total arousal, arousal index, AHI and oxygen reduction index were significantly decreased (P <0.001). There was also a reduction in the number of non-respiratory arousals (P <0.034). The number of respiratory related arousals, oxygen reduction index, total number of arousals, arousal index, and non-respiratory arousals were positively correlated with AHI (P <0.01). AHI micro-arousal index, respiratory related arousal frequency, total arousal frequency and oxygen reduction index were positively correlated (P <0.01 or P <0.05). There was no correlation between the number of respirations-induced waking and oxygen reduction index (r = 0.59, P = 0.012). Conclusions: The number of respirations-related arousals, total arousal, arousal index, AHI and oxygen reduction index of OSAHS patients decreased significantly after CPAP treatment, apnea disappeared and the number of respiration-independent arousal decreased but not obvious. CPAP is an effective method of treating OSAHS.