经鼻气道持续正压通气对OSAHS患者夜尿次数变化的影响

Effect of treatment with nasal continuous positive airway pressure on the number of nocturia in patients with ;obstructive sleep apnea hypopnea syndrome

目的：探讨经鼻气道持续正压通气（nCPAP）对 OSAHS患者夜尿次数增多的改善作用。方法选择2014年6月至2016年5月夜尿次数增多的中重度 OSAHS 患者74例,其中中度[15次/h≤呼吸暂停低通气指数（AHI）〈30次/h]14例、重度（30次/h≤AHI〈60次/h）31例和极重度（AHI≥60次/h）29例,进行 Auto-nCPAP滴定、记录 n-CPAP滴定当晚平均压力及治疗前后夜尿次数,并对其结果进行统计学处理。结果 OSAHS 患者夜尿次数与 AHI、ESS 评分、夜间最低血氧饱和度（LSpO2）相关（r=0.728、0.435、-0.293,P 值均〈0.05）,且随着 AHI 增大,夜尿次数逐渐增多；nCPAP治疗后夜尿次数明显减少,3组治疗前后P值均〈0.001,且当晚 nCPAP 压力与夜尿次数呈正相关（r=0.503,P〈0.001）,nCPAP压力〈9 cmH2 O 患者夜尿次数明显比 nCPAP压力≥9 cmH2O 组少,差异有统计学意义（1.30±1.10 vs 2.56±1.50,t=-3.999,P 〈0.001）。结论 nCPAP能改善 OSAHS患者夜间多尿症状,其治疗压力越低患者夜尿次数越少。

Objective To investigate the effect of treatment with nasal continuous positive airway pressure（nCPAP）on night urination number in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）.Methods Seventy-four patients diagnosed with moderate and severe OSAHS accompanying with nocturnal polyuria by polysomnography （PSG） monitoring and recording the number of nocturia were included,moderate group（n=14）,severe group（n=31）,extremely severe group（n=29）.The number of nocturia and pressure were measured and recorded before and after nCPAP treatment.Results The number of nocturia was correlated with apnea-hypopnea index （AHI）,the lowest nocturnal oxygen saturation （LSpO2） and ESS score （r =0.728,0.435,-0.293,P 〈0.05）,and nocturia gradually increased with the AHI increased,after nCPAP treatment the number of nocturia reduced significantly（P 〈0.001）.And nCPAP pressure was positively correlated with the number of nocturia （r=0.503,P 〈0.001）,nCPAP pressure 〈9 cmH2 O nocturia were significantly less than nCPAP pressure≥9 cmH2 O group（1.30±1.10 vs 2.56±1.50,t=-3.999,P 〈0.001）.Conclusions Treatment with nCPAP can improve symptoms on nocturnal polyuria in patients with OSAHS.And the lower the pressure,the less number of nocturia in patients with OSAHS.