CPAP治疗OSAHS合并脑卒中的临床研究

Clinical study of CPAP in treatment of OSAHS complicated with stroke

目的探讨持续气道正压通气(CPAP)对阻塞性唾眠呼吸暂停低通气综合征(OSAHS)合并脑卒中患者睡眠呼吸状况、认知功能及氧化应激反应的影响。方法将82例OSAHS合并脑卒中患者随机分为研究组(n=41)和对照组(n=41),对照组行常规治疗,研究组加CPAP治疗,均持续治疗12周。比较两组睡眠呼吸指标(ESS、PSQI评分及AHI、LSaO_(2))、认知功能指标(LOTCA、MoCA评分)及氧化应激因子(SOD、TAOC、MDA、OX-LDL)水平。结果两组睡眠呼吸指标、认知功能指标、氧化应激因子的时点效应、组间效应、交互效应,差异均有统计学意义(P<0.05)。治疗6周、12周,研究组ESS、PSQI评分及AHI、MDA、OX-LDL水平均低于对照组,LOTCA、MoCA评分及LSaO_(2)、SOD、TAOC水平均高于对照组,差异均有统计学意义(P<0.05)。结论CPAP可明显改善OSAHS合并脑卒中患者睡眠呼吸状况及认知功能,减轻氧化应激反应,应积极行CPAP干预,以改善预后。

Objective To investigate the effect of continuous positive airway pressure(CPAP)on sleep breathing,cognitive function and oxidative stress in obstructive salivary apnea hypopnea syndrome(OSAHS)patients complicated with stroke.Methods 82 OSAHS patients with stroke were randomly divided into the study group(n=41)and the control group(n=41).The control group was treated with routine treatment,and the study group was treated with CPAP for 12 weeks.The sleep respiratory index(ESS,PSQI scores and AHI,LSaO_(2)),cognitive function index(LOTCA,MoCA scores)and oxidative stress factor(SOD,TAOC,MDA and OX-LDL levels)were compared between the two groups.Results The time point effect,inter group effect and interaction effect of sleep breathing index,cognitive function index and oxidative stress factor between the two groups were statistically significant(P<0.05).After 6 weeks and 12 weeks of treatment,the ESS,PSQI scores and AHI,MDA,OX-LDL levels in the study group were lower than those of the control group,while the LOTCA,MoCA scores and LSaO_(2),SOD,TAOC levels in the study group were higher than those of the control group(P<0.05).Conclusion CPAP can significantly improve the sleep respiratory status and cognitive function of OSAHS patients complicated with stroke,and reduce oxidative stress.CPAP should be actively intervened to improve the prognosis.