连续正压通气对阻塞性睡眠呼吸暂停低通气综合征患者睡眠及氧化应激的影响  

Effect of Continuous Positive Airway Pressure Ventilation on the Sleep and Oxidative Stress in the Treatment of Patients with Obstructive Sleep Apnea Syndrom

作　　者：蒋康伦[1] 李姝娜[1] 赵琳[1] 钱炜[1] 林志强[1] 

机构地区：[1]江苏大学附属人民医院,镇江212002

出　　处：《世界睡眠医学杂志》2018年第1期94-99,共6页World Journal of Sleep Medicine

基　　金：镇江市社会科学发展支撑项目(SH2014045)--咽壁松弛度检测技术在临床应用研究

摘　　要：目的:探讨连续正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠及氧化应激的影响。方法:选取2015年3月至2016年2月江苏大学附属人民医院收治的OSAHS患者76例为研究组,均在常规治疗的基础上联合连续正压通气治疗;另选取同期来院体检的健康者60例为对照组。采用多导睡眠图(PSG)监测并记录研究组患者治疗前后睡眠质量及相关睡眠障碍指标的变化;另比较治疗前后研究组及对照组痰诱导物中炎性因子及血清氧化应激指标水平,分析患者氧化应激状态。结果:与治疗前比较,治疗后研究组患者觉醒时间明显缩短,觉醒次数及浅睡眠均明显减少,微觉醒指数明显降低(P<0.05或P<0.01);而深睡眠及快速动眼(REM)均明显增加(P<0.01);而治疗前后患者睡眠效率无明显变化(P>0.05);与治疗前比较,治疗后患者腿动指数、平均心率及最大心率均明显降低(P<0.01);而平均动脉氧饱和度、最小动脉氧饱和度均明显升高(P<0.01);与对照组比较,治疗前研究组患者痰诱导物中白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平及血清丙二醛(MAD)及硫氧还蛋白-1(TRX-1)水平均明显升高,血清超氧化物歧化酶(SOD)水平显著降低(P<0.01);与治疗前比较,治疗后研究组患者痰诱导物中IL-6、TNF-α水平及及血清MAD、TRX-1水平均明显降低,虽仍高于对照组,但与对照组间差异无统计学意义(P>0.05);血清SOD水平明显升高,虽仍低于对照组,但与对照组间差异无统计学意义(P>0.05)。结论:CPAP治疗OSAHS可显著改善患者睡眠质量,改善患者相关睡眠障碍指标,并明显抑制患者上呼吸道炎症反应,降低机体氧化应激水平,疗效显著。Objective： To explore the effect of continuous positive airway pressure ventilation（ CPAP） on the sleep and oxidative stress in the treatment of patients with Obstructive Sleep Apnea-Hypopnea Syndrome（ OSAHS）. Methods：A total of 76 cases of OSAHS patients in our hospital from Mar. 2015 to Feb. 2016 were elected as research group,which was treated with CPAP based on the conventional therapy; besides,a total of 60 cases of healthy people who were received physical examination during the same time were elected as control group. Monitored and recorded the changes of sleep quality and sleep disorders indexes in 2 groups before and after treatment by polysomnogram（ PSG）; compared the the inflammatory factors levels in phlegm inducer and the oxidative stress indexes in serum in 2 groups before and after treatment,analyzed the Oxidative stress state of OSAHS patients. Results： Compared with before treatment,the Wake up of time shortened,the number of awakening,light sleep and micro index of awakening decreased significantly in research group（ P 0. 05 or P 0. 01）; while the deep sleep and REM increased significantly in research group（ P 0. 01）;the sleep efficiency had no significant changes in 2 groups（ P 0. 05）. Compared with before treatment,the leg index,average heart rate and max heart rate decreased significantly（ P 0. 01）,while the mean arterial oxygen saturation and minimum arterial oxygen saturation increased significantly（ P 0. 01）. Compared with control group,the levels of IL-6,TNF-α in phlegm inducer and the levels of MAD,TRX-1 in serum increased significantly before treatment,while the levels of serum SOD decreased significantly in research group（ P 0. 01）. Compared with before treatment,the levels of IL-6,TNF-α in phlegm inducer and the levels of MAD,TRX-1 in serum decreased significantly,although which was still higher than that in control group,but there were no significant difference between 2 groups（ P 0. 05）; the levels of serum SOD increased significantly,

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 连续正压通气 睡眠质量 氧化应激 

分 类 号：R277.7[医药卫生—中医学] R742.5