持续气道正压通气对老年睡眠呼吸暂停患者神经损伤因子的影响

Effect of continuous positive airway pressure ventilation on nerve injury factor in elderly OSAHS patients

目的探讨不同时程持续气道正压通气(CPAP)对老年重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清S100β蛋白及神经元特异性烯醇化酶(NSE)的影响及意义。方法选择经多导睡眠仪(PSG)检查确诊的老年重度OSAHS患者为病例组,选取同期老年健康体检者90例为对照组。病例组给予CPAP治疗,治疗前及治疗后3、6个月采用PSG测最低血氧饱和度(LSaO_2)、平均血氧饱和度(MSaO_2)及呼吸暂停低通气指数(AHI),采用ELISA检测血清S100β蛋白和NSE水平。结果与治疗前比较,病例组治疗3、6个月较治疗前LSaO_2[(92.69±-2.12)%和(93.42±3.36)%vs(62.43±6.56)%]、MSaO_2[(94.43±4.65)%和(95.36±3.94)%vs(78.98±4.72)%]明显升高,AHI明显降低(P<0.05),病例组治疗前、治疗3、6个月血清S100β蛋白和NSE水平均显著高于对照组(P<0.05),病例组治疗6个月血清S100β蛋白[(0.56±0.12)μg/Lvs(0.98±0.11)μg/L]、NSE[(10.21±1.42)μg/Lvs(16.13±2.42)μg/L,P<0.05]均低于治疗3个月。结论 CPAP治疗能降低老年重度OSAHS患者神经系统的损害,其疗效与治疗时程有关,且可通过监测血清S100β蛋白及NSE水平的变化进行评估。

Objective To study the effect of continuous positive airway pressure（CPAP） on serum S100β and NSE in elderly OSAHS patients.Methods Ninety polysomnography-confirmed OSAHS patients served an OSAHS group and 90 persons undergoing physical examination served as a control group in this study.The LSaO2,MSaO2,AHI,and serum S100β and NSE levels were measured by polysomnography and ELISA respectively before and after 3 and 6 months of treatment.Results The LSaO2,MSaO2,and AHI were significantly higher in OSAHS group after 3and 6 months of treatment than before treatment（92.69%＋ 2.12%vs 62.43%± 6.56%,93.42%±3.36%vs 62.43%±6.56%,P〈0.05）.The serum S100β and NSE levels were significantly higher in OSAHS group before and after 3 and 6 months of treatment than in control group（P〈0.05） and were significantly lower in OSAHS group after 6 months of treatment than after 3months of treatment（P〈0.05）.Conclusion CPAP can reduce nervous system damage in elderly severe OSAHS patients.Its therapeutic effect is related with its treatment time and can be assessed by monitoring serum S100β and NSE levels.