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目的:探讨无创双水平正压通气(BiPAP)治疗重叠综合征(OS)对近期肺动脉压力(PAP)及膈肌疲劳的改善情况。方法:26例OS患者均在常规治疗基础上进行无创双水平正压通气治疗24 h,检测治疗前、后静息状态下肺阻抗血流图,同步电阻抗呼吸仪描记胸、腹部呼吸运动曲线。结果:BiPAP治疗后患者平均PAP较治疗前明显改善(P<0.01),PAP大于20 mmHg病人4例,较治疗前(20例)显著减少(P<0.01);OS患者膈肌疲劳发生率高达73.8%,而治疗后检出率降至15.4%。结论:无创双水平正压通气治疗OS能显著降低患者近期肺动脉压,改善膈肌疲劳。
Objective: To investigate the effect of noninvasive bi-level positive pressure ventilation (BiPAP) on pulmonary artery pressure (PAP) and diaphragmatic fatigue in patients with overlapping syndrome (OS). Methods: Twenty-six patients with OS were treated with noninvasive bi-level positive pressure ventilation for 24 hours on the basis of conventional therapy. Pulmonary impedance blood flow diagrams were measured before and after treatment. The respiratory impedance curves of chest and abdomen . Results: The average PAP of patients with BiPAP was significantly improved (P <0.01). Four patients with PAP greater than 20 mmHg were significantly reduced compared with those before treatment (P <0.01). The incidence of diaphragmatic muscle fatigue in OS patients was as high as 73.8 %, While the detection rate dropped to 15.4% after treatment. Conclusion: Noninvasive bi-level positive pressure ventilation can significantly reduce pulmonary hypertension and improve diaphragmatic fatigue in patients with OS.