压力滴定方式与持续正压通气依从性的关系

Relationship of CPAP pressure titration methods and CPAP compliance

目的研究整夜多导睡眠图(polysomnogra-phy,PSG)监测下进行人工压力滴定和自动压力滴定(Auto-set)的方法对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopne asyndrome,OSAHS)患者使用经鼻持续正压通气(continuous positive airway pressure,CPAP)治疗依从性的影响。方法2001～2004年在本睡眠工作室诊断的重度OSAHS并愿意尝试CPAP治疗的患者45例,根据患者意愿选择压力滴定方式,10例选择实验室PSG监测下滴定(A组),35例选择家用Auto-set进行自动压力滴定(B组)。完成压力滴定后,对表示愿意接受CPAP治疗的患者及其家属采取相关的教育措施,其中A组7例,B组25例。在患者接受CPAP治疗前和治疗后半年各进行1次生活质量问卷调查,比较治疗前、后问卷得分以反映CPAP的疗效。以每周用机小时数表示依从性,比较两组依从性。结果A、B组治疗前、后问卷得分下降情况接近,分别为14分和14.3分,两组CPAP疗效相同;A,B组的平均每天用机小时数接近,分别为4.91小时和4.97小时;A、B组的规律用机率接近,分别为85.7%(6/7)和88%(22/25)。结论采用两种不同压力滴定方法的患者其CPAP治疗的依从性是相同的。自动压力滴定是可以替代传统的实验室压力滴定法。

OBJECTIVE To study the relationship between the methods of CPAP pressure titration （under whole night PSG or by auto-set） and CPAP compliance. METHODS Forty-five patients with serious OSAHS who had been diagnosed in our sleep lab between 2001 and 2004 and were willing to try CPAP treatment were enrolled. They were divided into A and B group according to their wills： pressure titration under whole night PSG in lab （group A） or by auto-set in their families （group B）. After pressure titration, patients and their families were educated for the knowledge of CPAP treatment in OSAHS patients. Questionnaires about QOL before CPAP treatment and half year later were carded out on the phone. The decreased score was used to evaluate the effect of CPAP treatment. The hours of per day using machine were used to evaluate the compliance of CPAP. RESULTS Group A and group B got the similar decreased score （14 VS 14.3）, compliance （4.91h VS 4.97h） and adherence （85.7 % VS 88 %）. CONCLUSION OSAHS patients under go pressure titration either in lab with PSG or in their home with auto-set have the same effect and same compliance of CPAP treatment. That means the simple auto-titration can substitute the traditional titration under whole night in lab.