正压通气治疗睡眠呼吸暂停综合征并代谢综合征的研究

Therapeutic effect of CPAP in patients with sleep apnea syndrome and metabolism syndrome

目的:研究持续气道内正压通气(CPAP)对睡眠呼吸暂停综合征(SAS)并代谢综合征(MS)的疗效。方法:158例SAS并MS患者被随机分成两组,即CPAP治疗组(治疗组)和药物治疗组(对照组),治疗组在药物组治疗基础上加用CPAP治疗。两组患者于治疗前、治疗4周后分别行呼吸睡眠监测:动脉血氧饱和度(SaO2)、呼吸参数,并测空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2h血糖(2hPG)、餐后2h胰岛素(2hPINS)、胰岛素敏感性指数(ISI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)的变化。结果:与对照组比较,治疗组治疗后呼吸暂停和低通气均明显减少,打鼾消失,低氧发作次数减少,最低SaO2明显提高(P<0.01);同时血糖、胰岛素、TC、TG浓度,SBP、DBP均明显降低,HDL-C水平明显升高,与对照组比较有明显差异(P<0.01)。结论:CPAP治疗SAS并MS除能改善SAS病情外,还能加强药物疗效,改善代谢参数,降低血压,降低心脑血管病危险因素的程度。

Objective： To analyze the therapeutic effect in patients with sleep apnea syndrome （SAS） and metabolism syndrome （MS） by continuous positive airway pressure （CPAP）. Methods： A total of 158 patients with SAS and MS were randomly divided into two groups： CPAP treatment group （treatment group） and medication group （control group）. The treatment group was treated by CPAP on the base of treatment of medication group. The patients of two groups were separately measured the change of breathing and sleeping： SaO2, breath parameter; metabolism parameters： SBP and DBP. Results： After treated, breath pause and lower ventilate obviously reduced （P〈0.01）, snore disappeared, the times of low oxygen paroxysm decreased and the SaO2 increased obviously （P〈0.01） ; simultaneity, blood sugar, blood insulin, TC, TG levels and SBP, DBP decreased, the HDL-C level obviously increased （P 〈0.01） in treatment group, compared with those of control group. Conclusion： CPAP treatment except may improve SAS, also may improve metabolism parameters and blood pressure, so is an effective treatment method for patient with SAS and MS.