持续气道正压通气治疗对肥胖阻塞性睡眠呼吸暂停低通气综合征睡眠参数及血浆同型半胱氨酸水平的影响

Efficacy of Continuous Positive Airway Pressure Ventilation on the Sleep Parameters and Plasma Homocysteine in the Treatment of Obstructive Sleep Apnea-hypopnea Syndrome with Obesity

目的:初步探讨持续气道正压通气治疗对肥胖阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者睡眠参数及血浆同型半胱氨酸(homocysteine,HCY)水平的影响。方法:肥胖OSAHS组和非肥胖OSAHS组,各30例,行经鼻持续气道正压通气治疗(continuous positive airway pressure,CPAP)3个月,比较两组治疗前后多导睡眠监测相关指标、血浆HCY水平变化。结果:治疗前肥胖OSAHS组和非肥胖OSAHS组AHI分别为(44.51±20.69)次/h和(41.53±21.18)次/h,Mean SpO2分别为(86.01±5.06)%和(89.55±3.73)%,Min SpO2分别为(67.25±9.63)%和(70.91±10.36)%,RIT分别为(26.04±12.33)s/min和(23.67±12.76)s/min,血HCY分别为(14.73±4.01)μmol/L和(12.84±3.61)μmol/L,两组数据比较差异有统计学意义(P<0.05)。经CPAP治疗后,肥胖OSAHS组和非肥胖OSAHS组睡眠呼吸紊乱参数均得到改善,血浆HCY浓度均较治疗前下降,但肥胖OSAHS组HCY水平(12.79±2.82)μmol/L,仍高于非肥胖OSAHS组的(10.27±1.15)μmol/L(P<0.05)。结论:持续气道正压通气治疗能明显改善OSAHS患者的睡眠参数,降低HCY水平,但肥胖OSAHS患者HCY水平仍高于非肥胖OSAHS患者。

Objective: To investigate the roles of continuous positive airway pressure(CPAP) ventilation on the sleep parameters and plasma homocysteine in the treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS) with obesity.Method:30 OSAHS patients with obesity and 30 OSAHS patients without obesity patients from January 2012 to June 2018 accepted nasal continuous positive airway pressure(nCPAP) therapy for 3 month,the changes of data about polysomnography and the level of HCY were measured before and after CPAP.Result:Before CPAP,between OSAHS with obesity and OSAHS without obesity group,parameters apnea-hypopnea index(AHI) were (44.51±20.69 vs 41.53±21.18)times/h,as well as Mean SpO2 (86.01±5.06 vs 89.55±3.73)%,Min SpO2(67.25±9.63 vs 70.91±10.36)%,respirator impair time index(RIT)(26.04±12.33 vs 23.67±12.76)s/min and plasma HCY level(14.73±4.01 vs 12.84±3.61)μmol/L,respectively,which were different in two groups(P<0.05).After CPAP,all of the data about PSG were significant better than before in 2 groups,as the same time,the level of HCY decreased in the both 2 groups(P<0.05).But the HCY level of (12.79±2.82)μmol/L in the group of OSAHS with obesity was still higher than (10.27±1.15)μmol/L of the group of OSAHS without obesity(P<0.05).Conclusion:CPAP can improve the situation of sleep for OSAHS patients,and significantly decrease the level of HCY,but OSAHS patients with obesity have higher level of HCY than without obesity patients.