经鼻持续气道正压通气治疗阻塞性睡眠呼吸暂停综合征的压力水平研究  

predictionofthelevelofcontinuousoptimallevelofcontinuouspositiveairwaypressureinthemamage┐mentofobstructivesleepapnessyndromevianasalmask

作　　者：曾运祥[1] 钟南山[1] 

机构地区：[1]广州呼吸疾病研究所

出　　处：《中华结核和呼吸杂志》1996年第5期269-272,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的通过全夜多导睡眠图（ＰＳＧ）有关呼吸紊乱和低氧血症的指标，预测阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）患者所需的经鼻罩持续性气道内正压通气（ＣＰＡＰ）的最佳压力水平（Ｐｍ），并用于指导临床应用。方法采用ＲＨＫ－５５００型多导睡眠监测系统联接ＢｉＰＡＰ（ＳＴ／Ｄ）系统测定１８例ＯＳＡＳ患者经鼻罩ＣＰＡＰ的Ｐｍ，并推导其与呼吸紊乱指数（ＲＤＩ）或血氧饱和度低于９０％时间（ＴＳ９０）的回归方程。采用此回归方程预测Ｐｍ，并对６例（预测组）ＯＳＡＳ患者进行１周治疗（每夜８～１０小时），其结果与采用实测Ｐｍ进行ＣＰＡＰ治疗的１３例（实测组）ＯＳＡＳ患者（同样疗程）相对比。所有患者在治疗前和治疗后１～２天测定ＰＳＧ。结果ＲＤＩ或ＴＳ９０与Ｐｍ呈显著的直线正相关；用预测Ｐｍ治疗ＯＳＡＳ，其症状及ＰＳＧ指标均有显著改善，疗效与用实测Ｐｍ组者差异无显著性。ObjectiveTopredictanoptimallevelofcontinuouspositiveairwaypressure(CPAP)inthemenagementofobstructivesleepapneasyndrome(OSAS)ome(OSAS)byrelatingcertainparametersofrespira-torydisturbanceandsleephypoxemia.Metosd18patientswithOSAS(almale,aged48±11yrs)wereenroledinthestudy.TheiractuallevelsofCPAP(Pm)weredeterminedbyaRHK-5500mode-polysomnographicsystemplusBiPAP(ST/D)system.TheactualPmwasrelatedtotherespiratorydis-turbanceindex(RDI)ortotaltimeofSaO2≤90%(TS90).Thecorrelationregressionequationswerecal-culated.6patientswithOSAS(GroupA)weretreatedwiththepredictednasalCPAP(predictedPm)whichwasderivedfromtheregressionequation,8～10hourspernight,for5～7nights.13pa-tients(GroupB)receivingnasalCPAPtreatmentusingtheactualymeassuredPmservedascontrol.ResultsTherewasaclosepositivelinearcorelationbetweenRDIorTS90andactualPm.SymptomsandpolysomnographicparametersimprovedsignificantlyafteronecourseofCPAPtreatmentinGroupA.TheeficacyshowednosignificantdiferenceascomparedwiththatinGroupB.ConclusionsItwassug-gestedthatRDIorTS90areofvalueandsimpleinpredictingthepressurelevelofCPAPinthemanage-mentofOSASwithnasalCPAP.

关 键 词：睡眠呼吸暂停 综合征 气道内 正压通气 

分 类 号：R563.805[医药卫生—呼吸系统]