乙酰半胱氨酸片联合无创呼吸机治疗OSAHS的疗效及对氧化应激的影响

Effects of acetylcysteine tablets combined with noninvasive ventilator on OSAHS and oxidative stress

目的探讨乙酰半胱氨酸片联合无创呼吸机治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的效果，观察氧化应激水平变化情况。方法将山西博爱医院2014年12月至2016年12月收治的98例OSAHS患者纳入研究，根据随机数字表法分为对照组与观察组，每组49例。对照组采用无创呼吸机治疗，观察组在对照组基础上加用乙酰半胱氨酸片。比较两组治疗效果，并监测患者的氧减指数（ODI）、最低动脉血氧饱和度（LSaO2），测定超氧化物歧化酶（SOD）、晚期蛋白氧化产物（AOPP）、丙二醛（MDA）。结果观察组总有效率（93.88%）高于对照组（79.59%），差异有统计学意义（P〈0.05）。治疗后24周，两组ODI低于治疗前，LSaO2高于治疗前，且观察组ODI低于对照组、LSaO2高于对照组，差异有统计学意义（P〈0.05）。治疗后24周，两组MDA、AOPP低于治疗前，SOD高于治疗前（P〈0.05）；且观察组治疗后24周的AOPP低于对照组，治疗12、24周的MDA低于对照组，SOD高于对照组，两组比较差异有统计学意义（P〈0.05）。结论OSAHS患者在无创呼吸机治疗基础上加用乙酰半胱氨酸片，能改善氧减指数与LSaO2水平，进一步减轻氧化应激损伤，值得临床推广。

ObjectiveTo investigate the effects of acetylcysteine tablets combined with noninvasive ventilator on obstructive sleep apnea hypopnea syndrome （OSAHS）, and to observe the changes of oxidative stress in patients. MethodsNinety-eight OSAHS patients admitted in Shanxi Boai Hospital from December 2014 to December 2016 were enrolled in the study and were divided into control group and observation group according to random number table method, with 49 cases in each group. Patients in control group were given noninvasive ventilator treatment, patients in observation group were treated with acetylcysteine tablets based on therapy of control group. The therapeutic effects were compared between the two groups. The oxygen desaturation index （ODI） and the lowest oxygen saturation （LSaO2） were monitored; serum superoxide dismutase （SOD）, advanced protein oxidation products （AOPP） and malondialdehyde （MDA） were measured and compared between the two groups. ResultsThe total effective rate of observation group was higher than that of control group, the difference between the two groups was statistically significant （93.88% vs. 79.59%, P〈0.05）; at 24 weeks after treatment, the ODI of two groups were lower than that before treatment, the lowest SaO2 was higher than that before treatment, and the ODI of observation group was lower than that of control group （P〈0.05）; at 24 weeks after treatment, the levels of MDA and AOPP in the two groups were lower than those before treatment, SOD was higher than that before treatment （P〈0.05）, and the AOPP in observation group was lower than that in control group; at 12, 24 weeks after treatment, MDA in observation group was significantly lower than that in control group, SOD was significantly higher than that in control group （P〈0.05）.ConclusionsAcetylcysteine tablets combined with non-invasive ventilator treatment for OSAHS patients can improve the oxygen reduction index and the lowest level of SaO2, and further reduce oxidative stress injury, it is worthy of clinical promotion.