双水平气道正压通气对阻塞性睡眠呼吸暂停综合征和重叠综合征患者肺功能及血清C反应蛋白水平的影响研究

Impact of Bi-level Positive Airway Pressure Ventilation on Lung Function and Serum C-reactive Protein Level of Patients with Obstructive Sleep Apnea Syndrome or Overlap Syndrome

目的探讨双水平气道正压(Bi PAP)通气对阻塞性睡眠呼吸暂停综合征(OSAS)和重叠综合征(OS)患者肺功能及血清C反应蛋白(CRP)水平的影响。方法选择2012年6月—2014年6月在赣州市人民医院呼吸内科确诊的45例OSAS患者作为OSAS组,选择同期确诊的27例OS患者作为OS组。分别于Bi PAP通气治疗前及治疗1个月后行夜间多导睡眠图(PSG)监测,并于次日清晨抽取静脉血测定血清CRP水平,上午行肺功能检测。分别比较患者治疗前后呼吸暂停低通气指数(AHI)、呼吸暂停次数(AI)、最低血氧饱和度(最低Sp O2)、平均Sp O2、血清CRP水平、第一秒用力呼气末容积/用力肺活量(FEV1/FVC)、FEV1占预计值百分比(FEV1%)、FVC占预计值百分比(FVC%)及最大通气量占预计值百分比(MVV%);并分析两组患者血清CRP水平与肺功能指标的相关性。结果治疗1个月后,两组患者AHI、AI血清CRP水平分别低于治疗前,最低Sp O2、平均Sp O2、FEV1/FVC、FEV1%、FVC%、MVV%分别高于治疗前(P<0.01)。Pearson相关分析结果显示,OSAS组和OS组患者血清CRP水平分别与FEV1/FVC、FEV1%、FVC%及MVV%呈负相关(P<0.05)。结论对OSAS和OS患者行Bi PAP通气治疗可降低患者血清CRP水平,改善患者肺功能,从而提高患者生活质量。Bi PAP通气是治疗OSAS和OS的有效方法。

Objective To explore the impact of Bi - level positive airway pressure （BiPAP） ventilation on lung function and serum C - reactive protein （CRP） level of patients with obstructive sleep apnea syndrome （OSAS） or overlap ymlrome （OS）. Methods From _lune 2012 to June2014, 45 OSASpatients （OSASgroup） and 27 OSpatients （OSgroup） were selected, both grotgps given BiPAP ventilation. Before treatme~ and I month after treatment, polysomnography （PSG） was used to monitor apnea - hypopnea index （AHI）, apnea index （AI）, minimum oxygen saturation （ mini SpO2 ） , mean oxygen saturation （mean SpO2 ） , and serum CRP level was detected on the next day morning, lung function index including FEV1/ FVC, FEVt% , FVC% , MVV% was examined. Correlation betwee~ serum CRP leve~ and lung function index was analyzed. Results After 1 month of treatment, AHI, AI and serum CRP levet~ of l^th groups were lower than those before treatment, while mini Sp02, mean Sp02, FEV1/FVC, FEV1 %, FVC% and MVV% were higher than those before treatment （ P 〈 0.01）. Pearson correlation analysis showed that, serum CRP level of OSAS patients and OS patients was negatively correlated with FEVt/FVC, FEV1 %, FVC% and MVV%, respectively （ P 〈 0. 05 ）. Conclusion BiPAP ventilation is effective in treating 0SAS and 0S, ean reduce the serum CRP leveL, improve the lung function and the quality of life.