双水平气道正压通气治疗对重叠综合征患者肺动脉高压的影响研究

Study of influence of biphasic positive airway pressure ventilation on pulmonary artery hypertension in patients with overlap syndrome

目的 了解双水平气道正压通气治疗对重叠综合征患者血清心肌细胞缺氧诱导因子-1α（HIF-1α）、内皮素-1（ET-1）、血清促红细胞生成素（EPO）和平均肺动脉压（m PAP）的影响。方法 随机选取2013年7月-2016年6月诊治的80例重叠综合征患者,将其分为正压通气组（42例）和氧疗组（38例）,正压通气组给予双水平气道正压通气治疗,氧疗组给予夜间吸氧治疗。以30例健康成人为对照,比较两组组治疗前后的血清HIF-1α、ET-1、EPO和m PAP水平变化。结果 氧疗组和正压通气组治疗前的HIF-1α、ET-1、EPO和m PAP水平均显著高于对照组（P〈0.05）,两组间差异无统计学意义（P〉0.05）;两组治疗后的HIF-1α、ET-1、EPO和m PAP水平均显著低于治疗前（P〈0.05）,其中氧疗组治疗后的HIF-1α、ET-1、EPO和m PAP水平均显著高于正压通气组（P〈0.05）。结论 与常规氧疗比较,双水平气道正压通气治疗可有效降低重叠综合征患者血清中的HIF-1α、ET-1、EPO及m PAP水平,缓解肺动脉高压和改善缺氧状态。

Objective To explore the influence of biphasic positive airway pressure ventilation treatment on HIF-1α, ET-1,EPO and mPAP in patients with overlap syndrome.Methods 80 cases with overlap syndrome treated from July 2013 to June 2016 were divided into the positive airway pressure ventilation group （n=42） and oxygen therapy group （n=38）.Biphasic positive airway pressure ventilation method was given to the positive airway pressure ventilation group, while the oxygen therapy at night to the oxygen therapy group,30 healthy adults were selected as control group.The lev- el change of serum HIF-1α,ET-1,EPO and mPAP were compared before and after the treatment between two groups. Results The level of HIF-1α,ET-1,EPO and mPAP before therapy in the oxygen therapy group and the positive airway pressure ventilation group were all higher than those of the control group （P〈0.05）,while there was no statistical differ- ence between the positive eairway pressure ventilation group and oxygen therapy group （P〉0.05）.The level of HIF-1α, ET-1,EPO and mPAP after treatment in two groups were obviously shorter than those before treatment （P〈0.05）.The level of HIF-1α,ET-1,EPO and mPAP after treatment in the oxygen therapy group were all higher than those in the positive pressure ventilation group （P〈0.05）.Conclusion Biphasic positive airway pressure ventilation can reduce the level of HIF-1α,ET-1,EPO and mPAP in patients with overlap syndrome effectively,and it can relieve pulmonary artery hypertension.and improve the hypoxia.