无创呼吸机治疗对OSAHS患者血清C反应蛋白、内皮素-1及肿瘤坏死因子-α水平的影响  

Influence of noninvasive ventilator in the treatment of plasma C-reactive protein,endothelin-1 and tumor necrosis factor-α in patients with obstructive sleep apneahypopnea syndrome

作　　者：孟庆华[1] 李承红[1] 江城[1] 孔彬[1] 冯琼[1] 

机构地区：[1]江汉大学附属医院呼吸科,武汉市430015

出　　处：《实用医学杂志》2015年第23期3861-3863,共3页The Journal of Practical Medicine

基　　金：2010年度武汉市卫生局临床医学科研项目(编号:武卫[2010]42号)

摘　　要：目的:探讨无创呼吸机治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清C反应蛋白(CRP)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)水平的影响及临床意义。方法:采用平行开放的方法选取中重度OSAHS患者100例,均予以健康宣教,要求戒烟酒、低脂饮食和运动减肥等常规治疗;随机分为治疗组42例(加用无创呼吸机治疗),对照组44例(只进行常规治疗)。治疗12周后,观察两组患者治疗前后血清CRP、ET-1和TNF-α水平及多导睡眠监测(PSG)参数变化。结果:两组患者治疗后PSG参数呼吸紊乱指数(AHI)、氧减指数(ODI)、最低血氧饱和度(LSp O2)、平均血氧饱和度(MSp O2)均较治疗前明显改善(P<0.01),但治疗组改善程度明显高于对照组(P<0.01);两组患者血清CRP、ET-1和TNF-α浓度较治疗前均降低(P<0.05或P<0.01),但治疗组降低幅度明显大于对照组(P<0.05或P<0.01)。结论:无创呼吸机治疗在改善OSAHS患者PSG监测数据的同时可有效降低患者血清CRP、ET-1、TNF-α水平,减轻机体的炎症反应。Objective To investigate the effect of noninvasive ventilator therapy on serum C-reactive protein （CRP）, endothelin-1 （ET-1） and tumor necrosis factor-or （TNF-α） levels in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） and its clinical significance. Methods One hundred cases of moderate and severe OSAHS patients were selected by the method of parallel opening. All of the patients were given health education requirement, quitting smoking and wine, low fat diet and exercise to lose weight and other conventional treatment. The patients were randomly divided into the treatment group of 42 cases with noninvasive ventilator treatment, 44 cases treated with conventional treatment, to observe the changes of serum CRP, ET-1 and TNF-α levels and PSG parameters after 12 weeks in two groups. Results Apnea hypopnea index （AHI）, oxygen desaturation index （ODI）, the lowest oxygen saturation （LSpO2）, and the average oxygen saturation MSpO2 in OSAHS patients were significantly improved after treatment （P 〈 0.01 ）, but the degree of improvement in the two groups after treatment was significantly higher than the control group （P 〈 0.01 ）. Plasma CRP, ET-1 and TNF-α levels in the two groups after treatment were lower than before treatment （P 〈 0.05 or P 〈 0.01 ）, but the treatment group was significantly higher than that of the control group （P 〈 0.05 or P 〈 0.01 ）. Conclusion Noninvasive ventilator therapy in improving the OSAHS monitoring data of patients with PSG can effectively reduce the serum CRP, TNF-α, ET-1 level, reduce the body＇s inflammatory reaction.

关 键 词：阻塞性睡眠呼吸暂停综合征 无创呼吸机 C反应蛋白 内皮素-1 肿瘤坏死因子-Α 

分 类 号：R766[医药卫生—耳鼻咽喉科]