动态血压及代谢当量在中重度阻塞性睡眠呼吸暂停低通气综合征疗效评估中的应用  

Value of ambulatory blood pressure monitoring and treadmile exercise test with moderate to severe obstructive sleep apnea-hypopnea syndrome

作　　者：邹月娥[1] 王富森[1] 欧阳清彦[1] 凃爱兰 

机构地区：[1]广东省佛山市第二人民医院心电图室,广东佛山528000

出　　处：《中国现代医学杂志》2011年第4期514-517,共4页China Journal of Modern Medicine

基　　金：广东省佛山市医学类科技攻关项目(No:200708017)

摘　　要：目的探讨动态血压及代谢当量联合观察评估中重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的患者行悬雍垂腭咽成形术（UPPP）＋舌根射频消融术及舌托治疗疗效的可能性。方法对2003年8月~2009年4月在该院就诊的66例中重度OSAHS合并高血压患者根据耐受舌托情况及意愿分别行UPPP＋舌根射频消融术或舌托治疗,对比观察每种治疗方法治疗前后及两种治疗方法治疗6个月后的PSG指标（AHI、mSaO2）、代谢当量（METs）与24 h动态血压的变化。结果两种治疗方法治疗前及治疗后6个月PSG指标、METs和24 h动态血压的差异均有显著性（P〈0.05）,而两种治疗方法治疗后6个月PSG指标、METs和24h动态血压的差异无显著性（P〉0.05）。说明UPPP＋舌根射频消融术治疗及舌托治疗不仅能改善观察对象的AHI和SaO2,而且能有效提高其代谢当量及降低昼夜平均血压;两种治疗方法对中重度OSAHS的治疗疗效相近。结论 PSG、METs及24h动态血压监测联合观察可作为中重度OSAHS患者的疗效评价参数组合之一;UPPP＋舌根射频消融术及舌托治疗均为治疗中重度OSAHS患者有效方式。【Objective】 To determine the value of ambulatory blood pressure monitoring and treadmile exercise test in predicating patients with moderate to severe OSAHS treated by uvulopalatopharyngoplasty and tone base reduction or Oral Appliance.【Methods】 66 patients were treated by uvulopalatopharyngoplasty and tone base reduction.The data including PSG,ambulatory blood pressure monitoring and treadmile exercise test was analyzed.【Results】 There was statistically significant improvement in PSG and ambulatory blood pressure monitoring（SBPd,DBPd,SBPn,DBPn） and treadmile exercise test after uvulopalatopharyngoplasty and tone base reduction or Oral Appliance.【Conclusions】 As to moderate to severe OSAHS,the uvulopalatopharyngoplasty and tone base reduction or Oral Appliance may be one of the effective therapy.The data including PSG and ambulatory blood pressure monitoring or treadmile exercise test may be very useful in predicating effectiveness of treatment to OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 多导睡眠监测 24H动态血压监测 悬雍垂腭咽成形术 代谢当量 

分 类 号：R448[医药卫生—诊断学]