抑郁症合并OSA患者临床症状、糖脂水平的变化及超短期CPAP治疗的影响

Changes of clinical symptoms, glycolipid levels and the effect of ultra-short-term CPAP therapy in OSA patients with depression

目的 探讨抑郁症合并阻塞性睡眠呼吸暂停综合征(Obstructive Sleep Apnea, OSA)患者临床症状、糖脂水平的变化,同时观察在精神科住院环境下超短期持续气道正压通气治疗(Continuous Postive Airway Pressure, CPAP)的影响。方法 回顾性分析2017年4月~2022年5月在我院完成整夜多导睡眠呼吸监测的抑郁症患者,从中选取两组,分别为抑郁症组(n=42)、抑郁症合并OSA组(n=40)。比较两组被试者临床症状及糖脂水平。抑郁症合并OSA组按照治疗方案不同分为常规治疗组和CPAP联合治疗组,常规治疗组采用常规治疗方案,CPAP联合治疗组在常规治疗方案基础上加用超短期持续正压通气治疗。比较两组被试者治疗前后临床症状及糖脂水平变化的差异,观察超短期持续气道正压通气治疗的影响。结果 抑郁症合并OSA组GLU、TC、TG、HAMD评分、HAMA评分均高于抑郁症组,差异均有统计学意义(P<0.05);抑郁症共病OSA组AHI与HAMD评分呈正相关。治疗后,CPAP联合治疗组的糖代谢指标及抑郁情绪改善均明显优于常规治疗组。结论 抑郁症合并OSA患者存在更严重的糖脂水平紊乱及不良情绪,超短期CPAP治疗可优化患者的糖代谢情况,对抑郁症状的缓解有正性作用。

Objective To investigate the changes in clinical symptoms and glycolipid levels in patients with depression combined with Obstructive Sleep Apnea(OSA), and to observe the effects of continuous positive airway pressure(CPAP)in a psychiatric hospital.Methods We retrospectively analyzed the depression patients who completed overnight polysomnography monitoring in our hospital from April 2017 to May 2022.Two groups were selected, namely the depression group(n=42) and depression combined with the OSA group(n=40). The clinical symptoms and glucose and lipid levels were compared between the two groups. Depression combined with the OSA group was divided into a routine treatment group and a CPAP combined treatment group according to different treatment schemes. The routine treatment group was treated with a routine treatment scheme, while the CPAP combined treatment group was treated with ultra-short-term continuous positive pressure ventilation based ona routine treatment scheme. The differences in clinical symptoms and glucose and lipid levels between the two groups were compared before and after treatment, and the effects of ultra-short-term CPAP ventilation were observed. Results The GLU, TC, TG, HAMD, and HAMA scores in the depression combined with the OSA group were higher than those in the depression group, and the differences were statistically significant( P<0.05). There was a positive correlation between AHI and HAMD scores in the depression comorbid OSA group. After treatment, the improvement of glucose metabolism indexes and depressive mood in the CPAP group was significantly better than that in the control group.Conclusion Patients with depression complicated with OSA have more severe glucose and lipid disorders and bad moods.Ultra-short-term CPAP treatment can optimize the glucose metabolism of patients and has a positive effect on the remission of depressive symptoms.