双水平气道正压通气、持续正压通气对中重度OSAHS患者气道壁厚度及血液流变学、血管内皮功能的影响比较  

Influence of BIPAP, CPAP on airway wall thickness, hemorheology and vascular endothelial function in moderate and severe OSAHS patients

作　　者：周勇 蒋跃文 ZHOU Yong;JIANG Yue-wen(Qiyang County People's Hospital Respiratory Medicine,Yongzhou,Hunan 426100,China.)

机构地区：[1]祁阳县人民医院呼吸内科一区,湖南永州426100

出　　处：《中国处方药》2021年第8期4-7,共4页Journal of China Prescription Drug

摘　　要：目的探讨持续正压通气(CPAP)、双水平气道正压通气(BIPAP)对中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者气道壁厚度及血液流变学、血管内皮功能的影响。方法2018年1月~2020年2月间收治的中重度OSAHS患者92例,经随机数表法分为BIPAP组、CPAP组各46例。BIPAP组脱落1例、CPAP组脱落2例,最终BIPAP组45例、CPAP组44例。对比两组患者治疗2个疗程后通气指标水平、气道壁厚度、血液流变学参数水平、血管内皮功能标志物水平的差异。结果治疗2个疗程后,BIPAP组患者的FEV_(1)%pred、FEV_(1)/FVC水平高于CPAP组(P<0.05),组间治疗后PO2水平的差异无统计学意义(P>0.05);两组间前咽后壁、咽侧壁的软腭后区、舌后区、会厌后区厚度值差异无统计学意义(P>0.05);BIPAP组患者的全血黏度切变率、血浆黏度切变率、红细胞积聚指数水平低于CPAP组(P<0.05);BIPAP组患者的桡动脉脉搏波传导速度(PWV)、血管性假性血友病因子(vWF)、血栓调节蛋白(TM)、内皮素-1(ET-1)水平低于CPAP组患者,一氧化氮(NO)水平高于CPAP组患者(P<0.05)。结论BIPAP、CPAP均可改善中重度OSAHS患者病情,BIPAP在优化通气功能及血液流变学、减轻血管内皮损伤方面作用更为显著。Objective To investigate the effects of BIPAP,CPAP on airway wall thickness,hemorheology and vascular endothelial function in moderate and severe OSAHS patients.Methods 92 cases of moderate and severe OSAHS patients in our hospital during January 2018 to January 2020 were chosen as research subjects,they were divided into BIPAP group,CPAP group by random number table method with 46 cases in each group.1 case fell off in BIPAP group,2 cases in CPAP group,and finally 45 cases in BIPAP group and 44 cases in CPAP group.The differences of ventilation indexes levels,airway wall thickness,hemorheology parameters levels and vascular endothelial function markers levels between two groups were compared after two courses of treatment.Results After two courses of treatment,levels of FEV_(1)%pred and FEV_(1)/FVC in BIPAP group were higher than those in CPAP group(P<0.05),and there was no significant difference in PO2 level between two groups(P>0.05).There were no significant difference in thickness between two groups in posterior soft palate area,posterior tongue area and posterior epiglottis area(P>0.05).The whole blood viscosity shear rate,plasma viscosity shear rate and red blood cell accumulation index of BIPAP group were lower than those in CPAP group(P<0.05).Levels of PWV,vWF,TM and ET-1 in BIPAP group were lower than those in CPAP group,and level of NO was higher than that in CPAP group(P<0.05).Conclusion Both BIPAP and CPAP can improve the condition of moderate and severe OSAHS patients,and BIPAP plays a more significant role in optimizing ventilation function and hemorheology,and alleviating vascular endothelial injury.

关 键 词：OSAHS BIPAP CPAP 气道壁厚度 血液流变学 血管内皮功能 

分 类 号：R766[医药卫生—耳鼻咽喉科]