目的 探讨持续气道正压通气 (continuous positive airway pressure,CPAP)对于冠心病合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的血压以及白天嗜睡情况的干预效果。方法 选取我院收治的160例冠心病合并OSA患者作为研究对象,随机分为观察组(在药物治疗的同时应用CPAP治疗)和对照组(仅药物治疗),各80例,监测治疗前后各组患者的血压、Epworth嗜睡评分量表(即ESS评分),以及多次小睡潜伏时间试验 (multiplesleep latency test,MSLT)的变化。结果 治疗前,两组的血压水平、ESS评分及MSLT试验结果差异无统计学意义。治疗后两组的血压水平均有明显降低,两组24 h平均收缩压(24 h-MDBP)、24 h平均舒张压(24 h-MSBP)、白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)、夜间平均收缩压(nMSBP)及夜间平均舒张压(nMDBP)比较,观察组治疗后的分别为(130.8±11.9) mmHg,(85.5±2.9)mmHg,(131.9±10.2)mmHg,(86.1±3.5)mmHg,(128.4±18.66) mmHg,(83.7±4.1)mmHg,均显著优于对照组(P<0.05);两组ESS评分、MSLT、AMI,以及呼吸暂停时间比较,观察组治疗1个月,3个月的效果明显优于对照组,差异有统计学意义(P<0.05)。结论 CPAP能够促进冠心病合并OSA患者的血压趋于正常,改善昼间嗜睡情况。
Abstract
Objective To study the effect of CPAP (continuous positive airway pressure) on the blood pressure of patients with coronary heart disease combined with obstructive sleep apnea (OSA) and daytime sleepiness.Methods 160 patients with coronary heart disease combined with OSA were randomly divided into study group (medication combined with CPAP treatment) and control group (medication treatment). There were 80 cases in each group. The blood pressure, Epworth sleepiness scale (ESS score) and the change of multiple sleep latency test (MSLT) were observed.Results Before the treatment, there were no significant differences in the blood pressure level, ESS score and MSLT test Results between the two groups. After the treatment, the blood pressure levels significantly decreased in two groups. In the study group after treatment, the average systolic blood pressure (24 h-MDBP), 24 h average diastolic blood pressure (24 h-MSBP), the average systolic blood pressure (dMSBP) during the day, the average diastolic blood pressure (dMDBP) during the day, the average night systolic blood pressure (nMSBP) and average diastolic blood pressure at night (nMDBP) were:(130.8±11.9)mmHg,(85.5±2.9)mmHg,(131.9±10.2)mmHg,(86.1±3.5)mmHg,(128.4±18.66) mmHg,and(83.7±4.1)mmHg, there were significant differences(P<0.05). The effect, in the study group one month and three months after the treatment were better than in the control group,there were significant differences(P<0.05).Conclusions CPAP can improve the blood pressure in the patients with coronary heart disease and OSA and daytime sleepiness.
关键词
持续气道正压通气 /
冠心病 /
阻塞性睡眠呼吸暂停 /
血压 /
昼间嗜睡
Key words
CPAP /
coronary heart disease /
obstructive sleep apnea /
blood pressure /
daytime sleepiness
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参考文献
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