CPAP治疗OSAHS压力滴定方式选择-A、B还是C?  

Which is the best way of CPAP titration for OSAHS treatment: A,B or C?

作　　者：李庆云[1] 万欢英[1] 李敏[1] 刘嘉琳[1] 倪瑾华[1] 曹蓓[1] 温弗乐[1] 黄绍光[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院呼吸科,200025

出　　处：《临床肺科杂志》2007年第6期597-599,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的本研究评估三种不同的压力滴定方式首夜治疗的疗效及对OSAHS患者睡眠质量的影响。方法选取上海瑞金医院睡眠呼吸疾病诊疗中心就诊的中重度OSAHS患者60例，年龄24～72岁。随机采取不同的压力滴定方式，分为APAP（A组），BiPAP（B组）和CPAP（C组）各20例。同时行PSG监测，比较各组治疗前后呼吸暂停低通气指数（AHI），氧减指数（ODI），微觉醒指数（mArI）以及所滴定的最适压力，以及对微觉醒，睡眠效率的影响。结果滴定前及滴定后AHI，氧减指数，微觉醒指数三组间均无明显差异。A，B，C组平均压力依次为11．05±1．23cmH2O，9．65±1．93cmH2O，9．15±1．95cmH2O（P〈0．01）。睡眠参数的改善三组间无显著性差异。C组S3＋S4＋REM时相占TST百分比较治疗前明显增加（P〈0．05）。结论三种方式均可有效滴定并改善睡眠效率。传统CPAP治疗时深睡眠改善更明显。仅一夜APAP治疗能否确定最适CPAP治疗压力仍需进一步研究。Objective To evaluate the efficacy and influence on sleep efficiency by three different types of titration process at titration night. Methods 60 cases of OSAHS （ moderate to severe） from Ruijin Sleep Disorder Study Center, aged 24 - 72 yrs old （ average 4.9.40 ±11.4.7 yrs）, were divided into three groups according to various pressure titration method, i.e. Group A, B and C （ titrated by using auto-CPAP, i.e. APAP, BiPAP and standard CPAP, respectively for the three groups）. Polysomnography （PSG） was carried on to compare difference of parameters between diagnose and titration night, including apnea-hypopnea index （AHI）, oxygen desaturation index （ODI）, microarousal index （mArI）. The effective pressure, and influence on the mArI and sleep efficiency by titration process were also compared among the 3 groups. Results After treatment, there was no difference in AHI, ODI, mArI and sleep efficiency among the groups. The average pressures were different significantly as indicated in the means of 11.05 ±1.23 cmH2O （ Group A）, of 9. 65±1.93 cmH2O （Group B） , and of 9. 15±1.95 cmH2O （Group C ） , respectively （P 〈 0. 01 ）. No difference was found for the improvement of sleep efficiency. The SSI of post treatment was less than that of pre-treatment in all three groups. In Group C, S3 ＋ S4 ＋ REM percentage increased significantly compared with pre-treatment （ P 〈 0. 05 ）. Conclusion All three types can titrate effectively without any difference on sleep efficiency improvement. The average pressure of APAP was the highest. Deep sleep improved significantly in Group C. It might need further study whether single-night APAP treatment is most appropriate for confirming the effectiveness of using CPAP pressure.

关 键 词：压力滴定 CPAP OSAHS 睡眠效率 依从性 

分 类 号：R56[医药卫生—呼吸系统]