改善高血红蛋白对中重度OSA的疗效研究

Study on the Therapeutic Effect of Reducing Hemoglobin on Moderate to Severe OSA

目的:临床观察快速降低血红蛋白法在中重度OSA合并高血红蛋白血症患者治疗中的作用。方法:选取2016年1月至2018年1月甘肃省人民医院睡眠医学中心收治的经PSG明确诊断为中重度OSA且血红蛋白浓度> 175 g/L的患者95例作为研究对象。根据患者是否愿意接受降低红细胞治疗,分为观察组(n=51)和对照组(n=44),观察组使用CPAP和降低血红蛋白治疗,对照组进行单纯CPAP治疗,治疗1周和治疗24周后,分别测量PSG、ESS评分、血气氧分压并观察记录患者头昏、胸闷、发绀等症状改善情况。结果:治疗1周后,与对照组比较:观察组最长呼吸暂停时间、ESS评分下降;血气氧分压、夜间最低血氧饱和度上升;头昏、胸闷、发绀等症状缓解;而AHI差异无统计学意义(P> 0. 05);治疗24周后,观察组患者多项指标与对照组比较均差异有统计学意义(P <0. 05)。结论:快速降低高血红蛋白对于OSA合并高血红蛋白血症患者的治疗效果良好。

Objective: To observe the therapeutic effect of rapid reduction of hemoglobin in the treatment of moderate to severe OSA patients with high hemoglobin. Methods: A retrospective study was performed on 95 patients with moderate to severe OSA diagnosed by PSG and hemoglobin concentration>175 who were admitted to the sleep medicine center of Gansu provincial people′s hospital from January 2016 to January 2018.Patients were divided into observation group( n =51)and control group( n =44).The observation group received with CPAP therapy and reducing hemoglobin,and the others in the control group received the CPAP therapy.To detect blood gas analysis,record the PSG,ESS score,and observe the improvement of symptoms like dizziness,chest tightness,cyanosis and other symptoms for 1 week and 6 months after treatment. Results: One week after treatment,compared with the control group,the longest apnea time,ESS score decreased,partial pressure of blood gas and oxygen,the lowest oxygen saturation at night increased,dizziness,chest tightness,cyanosis and other symptoms were relieved in the observation group,but there was no significant difference in AHI( P >0.05).There were statistically significant differences in various indicators between the observation group and the control group( P <0.05)after 24 weeks of treatment. Conclusion: Rapid reduction of hemoglobin has a good therapeutic effect on patients with OSA associated with high hemoglobin.