盐酸曲唑酮联合BiPAP通气对阻塞性睡眠呼吸暂停患者血清PPAR-γ、YKL-40、vWF水平的影响

Effect of trazodone hydrochloride combined with BiPAP ventilation on serum PPAR-γ,YKL-40 and vWF levels in patients with obstructive sleep apnea hypopnea syndrome

目的观察盐酸曲唑酮联合无创性气道双水平正压(noninvasive bi-level positive airway pressure,BiPAP)通气对阻塞性睡眠呼吸暂停(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血清过氧化物酶体增殖物激活受体γ(peroxisome proliferator activated receptor-γ,PPAR-γ)、甲壳质酶蛋白(chitinase protein,YKL-40)、血管性血友病因子(von willebrand factor,vWF)水平的影响。方法选取OSAHS患者162例,根据计算机随机分组,分为对照组和研究组,各81例。对照组给予BiPAP通气治疗,研究组给予盐酸曲唑酮联合BiPAP通气治疗,两组均治疗40 d。对比两组疗效、匹兹堡睡眠质量量表(Pittsburgh sleep quality scale,PSQI)评分、OSAHS患者专用生活质量量表-Calgary生活质量指数(Calgary quality of life index,SAQLI)评分、呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))、平均血氧饱和度(mean oxygen saturation,MSaO_(2))、血清PPAR-γ、YKL-40、vWF水平和不良反应发生率。结果治疗后,研究组的临床总有效率明显优于对照组(P<0.05)。治疗后,研究组PSQI评分低于对照组,SAQLI评分高于对照组(P<0.05)。治疗后,研究组AHI低于对照组,LSaO_(2)、MSaO_(2)高于对照组(P<0.05)。治疗后,研究组血清PPAR-γ、YKL-40、vWF水平低于对照组(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论盐酸曲唑酮联合BiPAP通气治疗OSAHS患者,可帮助患者症状改善,通过改善患者睡眠质量而提高其生活质量,同时还可下调血清PPAR-γ、YKL-40、vWF水平。

Objective To observe the effect of trazodone hydrochloride combined with noninvasive bi-level positive airway pressure(BiPAP)ventilation on serum peroxisome proliferator activated receptor-γ(PPAR-γ),chitinase-like protein(YKL-40)and von Willebrand factor(vWF)levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods In total,162 patients with OSAHS were selected and randomly divided into the control group and the research group,with 81 cases in each group.The control group was given BiPAP ventilation treatment,and the research group was given trazodone hydrochloride combined with BiPAP ventilation treatment.Both groups were treated for 40 d.The efficacy,Pittsburgh sleep quality scale(PSQI)score,Calgary quality of life index(SAQLI)for OSAHS patients,apnea hypopnea index(AHI),lowest oxygen saturation(LSaO_(2)),mean oxygen saturation(MSaO_(2))and serum PPAR-γ,YKL-40,vWF and the incidence of adverse reactions were compared between two groups.Results After treatment,the total effective rate of the research group was significantly better than that of the control group(P<0.05).After treatment,the PSQI score of the research group was lower than that of the control group,while the SAQLI score was higher than that of the control group(P<0.05).After treatment,AHI in the research group was lower than that in the control group,while LSaO_(2) and MSaO_(2) in the research group were higher than those in the control group(P<0.05).After treatment,the serum PPAR-γ,YKL-40 and vWF in the research group were lower than those in the control group(P<0.05).There was no difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion Trazodone hydrochloride combined with BiPAP ventilation in the treatment of OSAHS patients can help ameliorate the symptoms,enhance the quality of life by improving the sleep quality of patients,and reduce the serum PPAR-γ,YKL-40and vWF levels.