双水平气道正压通气对老年阻塞性睡眠呼吸暂停低通气综合征患者血气及认知功能的影响

Effect of Double Level Positive Airway Pressure on Blood Gas and Cognitive Function in Elderly Patients with Obstructive Sleep Apnea Hypopnea Syndrome

目的:探讨在老年阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea Hypopnea Syndrome,OSAHS)患者中应用双水平气道正压通气(Bi-Level Positive Airway Pressure,BiPAP)对其血气和认知功能的影响。方法:选取2017年5月至2018年5月重庆医科大学附属第二医院呼吸内科收治的老年OSAHS患者88例,以SPSS 24. 0软件生成随机数字表将患者随机分为观察组和对照组,每组44例。对照组给予常规治疗,观察组另应用BIPAP治疗,比较2组治疗前后的嗜睡情况、睡眠质量、血气指标和认知功能。结果:治疗后2组的Epworth嗜睡量表(ESS)评分和匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分均降低,观察组低于对照组,2组比较差异有统计学意义(P <0. 05); 2组治疗后的pH值、动脉血氧分压(Partial Arterial Oxygen Pressure,PaO_2)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)评分均提高,(P <0. 05),观察组高于对照组(P <0. 05)。结论:将BIPAP应用于老年OSAHS患者中,不仅可改善患者的嗜睡情况,提高睡眠质量,还可改善患者的血气指标和认知功能。

Objective: To investigate the effect of Obstructive Sleep Apnea Hypopnea Syndrome( OSAHS) on blood gas and cognitive function in elderly patients with Obstructive Sleep Apnea Hypopnea Syndrome( OSAHS) by using bilevel Positive Airway Pressure( BiPAP). Methods: A total of 88 elderly OSAHS patients admitted to the department of respiratory medicine of the second affiliated hospital of chongqing medical university from May 2017 to May 2018 were selected and randomly divided into observation group and control group with a random number table generated by SPSS 24. 0 software,with 44 cases in each group. The control group was given routine treatment,and the observation group was treated with BIPAP. The narcolepsy,sleep quality,blood gas indexes and cognitive function before and after treatment were compared between the two groups. Results: After treatment,Epworth sleepiness scale( ESS) score and Pittsburgh Sleep Quality Index( PSQI) score in both groups were significantly lower than those in the control group,and the difference between the two groups was statistically significant( P < 0. 05). The p H value,Partial Arterial Oxygen Pressure( PaO2)and Montreal Cognitive Assessment( MoCA) score of the two groups was statistically significant( P < 0. 05),and the observed group was higher than the control group,the difference was statistically significant( P < 0. 05). Conclusion:Applying BIPAP to elderly OSAHS patients can not only improve their drowsiness and sleep quality,but also improve their blood gas index and cognitive function.