连续正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者炎性反应和氧化应激标记物的影响

Effects of Continuous Positive Pressure Ventilation on Inflammatory and Oxidative Stress Markers in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

目的:探讨连续正压通气(CPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效.方法:选取2016年7月至2018年7月深圳市宝安区沙井人民医院收治OSAHS患者40例作为研究对象,全部患者均经多导睡眠图(PSG)诊断为中重度OSAHS,均进行为期3个月的CPAP治疗,对比治疗前后多导睡眠图指标、痰诱导标志物及血清标志物变化.结果:治疗后AHI、ODI、REM、觉醒指数、SaO2 及最低血氧饱和度等指标均显著优于治疗前(P<0.05);相较于治疗前,治疗后IL-6、TNF-α、硝基酪氨酸、8-异前列腺素等指标均明显改善(P<0.05);治疗后硝基酪氨酸、8-异前列腺素等指标较治疗前明显改善;CRP、IL-6、TNF-α与治疗前比较,差异无统计学意义(P>0.05).结论:CPAP对OSAHS患者而言是一种安全、有效的治疗方式,可有效降低患者上气道氧化应激与炎性反应水平,显著改善全身血清氧化应激水平,但在改善患者全身炎性反应上作用不显著.

Objective:To investigate the clinical efficacy of continuous positive pressure ventilation(CPAP)in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 40 patients with OSAHS were treated in our hospital from July 2016 to July 2018.All patients were diagnosed as moderate to severe OSAHS by polysomnography(PSG).All patients were treated with CPAP for 3 months.The changes of polysomnography,sputum induction markers and serum markers were compared before and after treatment.Results:After treatment,the indexes of AHI,ODI,REM,awakening index,SaO 2 and lowest oxygen saturation were significantly better than those before treatment,P<0.05;Compared with before treatment,the indexes of IL-6,TNF-a,nitrotyrosine and 8-Isoprostaglandin were significantly improved after treatment,P<0.05;after treatment,the indexes of nitrotyrosine and 8-Isoprostaglandin were significantly improved compared with those before treatment;CRP,IL-6,TNF-a were significantly improved compared with those before treatment.No significant difference,P>0.05.Conclusion:CPAP is a safe and effective treatment for OSAHS patients.It can effectively reduce the level of oxidative stress and inflammation in upper airway and significantly improve the level of oxidative stress in serum,but it has no significant effect on improving systemic inflammation.