持续气道正压通气治疗OSAHS合并咳嗽性晕厥的临床观察  

Clinical observation of continuous airway positive pressure ventilation in patients with obstructive sleep apnea hypopnea syndrome and cough syncope

作　　者：韩梅香[1] 曹洁[1] 王彦[1] 周宁[1] 陈宝元[1] 

机构地区：[1]天津医科大学总医院呼吸科,300052

出　　处：《天津医药》2016年第4期487-490,共4页Tianjin Medical Journal

基　　金：国家十二五科技支撑计划项目(2012BAIO5BO2)

摘　　要：目的研究持续气道正压通气（CPAP）治疗对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并咳嗽性晕厥患者相关症状的改善程度。方法收集我院呼吸内科收治的OSAHS合并咳嗽性晕厥患者43例,收集其病历资料和睡眠问卷,分析OSAHS各项指标与晕厥次数的相关性,予患者CPAP治疗,半年后根据CPAP依从性不同将患者分为依从性好组（26例）,依从性差组（17例）;比较2组治疗前后的睡眠呼吸暂停低通气指数（AHI）及C-反应蛋白（CRP）改善情况。结果 OSAHS患者的AHI、体质指数、CRP、嗜睡评分、颈围、腹围均与咳嗽性晕厥累计发生次数呈正相关（r分别为0.612、0.431、0.224、0.654、0.435、0.344,均P〈0.05）。所有患者经过CPAP及药物治疗1~2周后,均未再发生咳嗽性晕厥。出院半年后随访,CPAP依从性好的患者未再发生咳嗽性晕厥,CPAP依从性差的患者中少数患者咳嗽性晕厥仍有发生,但发生次数减少。治疗前,2组AHI（45.00±15.69 vs.48.70±16.47）、CRP（3.46±1.15 vs.3.38±0.72）无明显差异。治疗后依从性好组AHI（26.97±14.06 vs.48.18±15.96）、CRP（1.56±0.76 vs.3.18±0.78）均低于依从性差组（均P〈0.01）。结论及时持续治疗睡眠呼吸暂停疾病有助于减少患者咳嗽性晕厥的发生,并明显改善患者的AHI、CRP及咳嗽等相关症状。Objective To observe the curative effect of continuous airway positive pressure ventilation（CPAP） in patientswith obstructive sleep apnea hypopnea syndrome（OSAHS） and cough syncope. Methods Forty-three hospitalized patients withOSAHS and cough syncope were collected in the Department of Respiration of Tianjin General Hospital, and analyzed the relatedinformation. They were given CPAP treatment, and were divided into good compliance group（n=26） and poor compliance group（n=17） according to CPAP compliance after a half-year treatment. The apnea hypoventilation index（AHI） and c-reactive protein（CRP） were compared before and after treatment between two groups. Results The positive correlation was found between thefrequency of the cough syncope and indicators of OSAHS, such as AHI, body mass index（BMI）, CRP, sleepiness score（ESS） andcircumference of abdomen and neck（r= 0.612, 0.431, 0.224, 0.654, 0.435 and 0.344,P 0.05）. All these patients were curedafter the treatment of both CPAP and medication for 1 or 2 weeks. During a half-year follow-up, the cough syncope didn＇t occurin those patients of good compliance group, otherwise cough syncope still happened but with less frequency in patitents of poorcompliance group. Before the treatment, there was no significant difference in AHI（45.00±15.69 vs. 48.70±16.47） and CRP（3.46±1.15 vs. 3.38±0.72） between the two groups. After treatment, AHI（26.97±14.06 vs. 48.18±15.96） and CRP（1.56±0.76 vs. 3.18±0.78） were significantly lower in the good compliance group than those of the poor compliance group（P 0.01）. Conclusion Timely and sustained treatment of OSAHS may help reduce the incidence of cough syncope and significantly improve AHI, CRPand cough symptoms.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 呼吸暂停低通气指数 体质量指数 C-反应蛋白 持续气道正压通气 咳嗽性晕厥 

分 类 号：R562[医药卫生—呼吸系统]