持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者降压疗效的Meta分析  

Continuous positive airway pressure for treating high blood pressure of patients with obstructive sleep apnea-hypopnea syndrome: a meta-analysis

作　　者：李君[1] 李晓艳[1] 蒋学俊[1] 万为国[1] 刘万里[1] 

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060

出　　处：《海南医学》2015年第6期909-914,共6页Hainan Medical Journal

摘　　要：目的客观评价持续气道正压通气(CPAP)对改善阻塞性睡眠呼吸暂停综合征(OSAHS)患者高血压的疗效。方法计算机检索Cochrane图书馆、Pub Med、Web of Science、万方数据库、中国学术期刊网(CNKI)、中国生物医学文献数据库(CBM)从建库至2014年6月收录的CPAP对改善OSAHS患者高血压的临床随机对照试验(Randomized controlled trial,RCT),并对纳入的中英文文献采用Rev Man 5.0软件进行Meta分析。结果共纳入11个RCT,1 007例患者纳入研究,其中CPAP治疗组505例,对照组502例。Meta分析结果显示:OSAHS患者经CPAP治疗后白天收缩压、舒张压,夜间收缩压、舒张压,全天24 h平均收缩压、舒张压减低均优于对照组,差异具有统计学意义[白天收缩压:WMD=-7.31,95%CI(-10.82,-3.80),P<0.000 1;白天舒张压:WMD=-5.11,95%CI(-7.11,-3.11),P<0.000 1;夜间收缩压:WMD=-9.34,95%CI(-12.37,-6.31),P<0.000 1;夜间舒张压:WMD=-6.35,95%CI(-9.15,-3.54),P<0.000 1;全天24 h收缩压:WMD=-5.82,95%CI(-8.32,-3.32),P<0.000 1;全天24 h舒张压[WMD=-4.73,95%CI(-6.02,-3.44),P<0.000 1]。漏斗图基本对称,发表偏倚可能性小。结论 CPAP对改善阻塞性睡眠呼吸暂停综合征患者高血压的疗效确切。Objective To evaluate the efficacy of continuous positive airway pressure（CPAP） for treating high blood pressure of obstructive sleep apnea-hypopnea syndrome（OSAHS）. Methods The related literature of CPAP for treatment of high blood pressure of OSAHS were searched by computer from Cochrane Library, Pub Med,Web of Science, Wanfang Database, CBM and CNKI update to June, 2014. The selected studies in Chinese and English were used for meta-analysis with software Rev Man 5.0. Results Eleven studies, including 1 007 cases（CPAP group：505 cases, Control group： 502 cases）, were included in the study. Daytime systolic blood pressure（BP） and diastolic BP was significantly reduced by CPAP treatment compared with control group [WMD=-7.31, 95% CI（-10.82,-3.80）, P〈0.000 1 and WMD=-5.11, 95% CI（-7.11,-3.11）, P〈0.000 1, respectively]. Night-time systolic BP and diastolic BP in CPAP group were significantly better than control group [WMD=-6.35, 95% CI（-9.15,-3.54）, P〈0.000 1 and WMD=-5.82, 95%CI（-8.32,-3.32）, P〈0.000 1, respectively]. 24 h mean systolic BP and diastolic BP had also the same superiority in the CPAP group [WMD=-5.82, 95%CI（-8.32,-3.32）, P〈0.000 1 and WMD=-4.73, 95%CI（-6.02,-3.44）,P〈0.000 1, respectively]. The funnel schema was nearly symmetry with little bias. Conclusion Treatment with CPAP significantly reduces BP in patients with OSAHS.

关 键 词：持续气道正压通气 睡眠呼吸暂停综合征 阻塞性 高血压 META分析 

分 类 号：R442.8[医药卫生—诊断学]