无创正压通气治疗对OSAHS患者血清同型半胱氨酸和红细胞压积的影响研究

Effect Research of Non-Invasive Positive Pressure Ventilation Treatment on Serum Homocysteine and Hematocrit of OSAHS Patients

目的观察无创正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者血清同型半胱氨酸和血红细胞压积的影响。方法将中重度OSAHS患者60例随机分为治疗组和对照组,各30例。治疗组给予无创正压通气治疗,对照组未接受无创正压通气治疗。两组均在入选第1天和3个月后检测血清同型半胱氨酸和红细胞压积的水平,计算出两组的前后差值后进行对比分析,并对比两组患者的睡眠指标和生活质量水平。结果治疗第1天两组患者的全血红细胞压积(Hct)、血清同型半胱氨酸(Hcy)、呼吸暂停低通气指数(AHI)以及夜间动脉血氧饱和度(SaO_(2))对比差异无统计学意义(P>0.05),治疗3个月后两组患者的Hcy、Hct、AHI以及夜间平均SaO_(2)水平相较于治疗第1天均有改善(P<0.01),其中治疗组的Hcy、Hct以及AHI水平低于对照组,而夜间平均SaO_(2)水平高于对照组,差异有统计学意义(P<0.01);治疗3个月后治疗组的物质生活状态、社会功能、心理功能以及躯体功能评分均高于对照组,差异有统计学意义(P<0.01)。结论对中重度OSAHS患者给予无创机械通气治疗不仅能改善夜间低氧,降低睡眠AHI,还可以减少血清同型半胱氨酸及红细胞压积的含量,从而降低心血管疾病的发生风险,达到提高患者的生活质量水平的目的。

Objective To observe effect of non-invasive positive pressure ventilation treatment on serum homocysteine and hematocrit of patients with obstructive sleep apnea hypopnea syndrome.Methods The paper chose 60 patients with moderate and severe OSAHS,and divided them into two groups randomly.Treatment group(30 patients)was treated with non-invasive positive pressure ventilation,with respiratory rate of 12~16 times/min and the titration pressure of 6~12cmH_(2)O,no less than 6h per night.30 cases in control group were not treated with non-invasive positive pressure ventilation treatment.Both groups were tested for serum homocysteine and hematocrit levels on the first day and three months after enrollment.Difference between two groups was calculated for comparative analysis,sleep indicators and life quality levels between two groups were compared.Results On the first day of treatment,whole blood hematocrit(Hct),serum homocysteine(Hcy),apnea hypopnea index(AHI)and nighttime arterial oxygen saturation(SaO_(2))between two groups showed no statistically significant difference(P>0.05).Three months after treatment,Hcy,Hct,AHI and nighttime average SaO_(2) levels between two groups were better than the first day of treatment(P<0.01).Levels of Hct and AHI were lower than control group,while average level of SaO_(2) at night was higher than control group,with statistically significant difference(P<0.01).After three month of treatment,scores of material life status,social function,psychological function and physical function in treatment group were higher than control group,with statistical significance(P<0.01).Conclusion Non invasive mechanical ventilation treatment can improve nocturnal hypoxia and reduce sleep AHI,levels of serum homocysteine and hematocrit,risks of cardiovascular disease and improve life quality of patients with moderate to severe OSAHS.