本文關(guān)鍵詞：持續(xù)正壓通氣聯(lián)合減重治療阻塞性睡眠呼吸暫停低通氣綜合征伴肥胖患者的初步研究　出處：《上海醫(yī)學(xué)》2017年02期 　論文類型：期刊論文

  更多相關(guān)文章： 阻塞性睡眠呼吸暫停低通氣綜合征 持續(xù)正壓通氣 減重 肥胖

【摘要】：目的探討持續(xù)正壓通氣(CPAP)聯(lián)合減重治療阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)伴肥胖患者的臨床療效。方法將60例OSAHS伴肥胖患者隨機(jī)分入CPAP治療組、減重治療組和聯(lián)合治療組,每組20例,分別予CPAP、減重和兩者聯(lián)合治療3個(gè)月。觀察并比較3組患者治療前后自體變化,如體重、BMI、頸圍、腰圍等;睡眠狀態(tài),如最長呼吸暫停時(shí)間(LAT)、呼吸暫停低通氣指數(shù)(AHI)、最低動(dòng)脈血氧飽和度(LS_aO_2)的改善情況;肺功能,如補(bǔ)呼氣量占預(yù)計(jì)值的百分比(ERV%)、用力肺活量占預(yù)計(jì)值的百分比(FVC%)的改善情況。結(jié)果 CPAP治療組患者治療后的體重顯著重于同組治療前(P0.05),BMI、頸圍、腰圍均顯著大于同組治療前(P值均0.05);減重治療組和聯(lián)合治療組患者治療后的體重均顯著輕于同組治療前(P值分別0.05、0.01),BMI、頸圍、腰圍均顯著小于同組治療前(P值分別0.05、0.01);聯(lián)合治療組患者治療前后的體重差值、BMI差值、頸圍差值、腰圍差值均顯著大于減重治療組(P值均0.01)。3組患者治療后的LAT均顯著短于同組治療前(P值分別0.01、0.05),AHI均顯著低于同組治療前(P值均0.01),LS_aO_2均顯著高于同組治療前(P值分別0.01、0.05)。聯(lián)合治療組患者治療前后的LAT差值、AHI差值、LS_aO_2差值均顯著大于其他兩組(P值均0.01)。CPAP治療組患者治療后的ERV%和FVC%均顯著小于同組治療前(P值均0.01),減重治療組和聯(lián)合治療組患者治療后的ERV%和FVC%均顯著大于同組治療前(P值均0.01)。聯(lián)合治療組患者治療前后的ERV%差值和FVC%差值均顯著大于減重治療組(P值均0.01)。結(jié)論 OSAHS伴肥胖患者在接受CPAP治療的同時(shí),還應(yīng)該接受在一定范圍內(nèi)的減重治療。
[Abstract]:Objective to explore the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with continuous positive pressure ventilation (CPAP) combined with weight loss. Methods 60 OSAHS patients with obesity were randomly divided into CPAP treatment group. The weight loss group and the combined treatment group, 20 cases in each group, were treated with CPAP, weight loss and combined treatment for 3 months. The autologous changes of the patients before and after treatment were observed and compared, such as body weight, BMI, neck circumference. Waist circumference, etc. The improvement of sleep status, such as the longest apnea time, apnea hypopnea index (AHIHV), lowest arterial oxygen saturation (LSSAO _ 2); Lung function, such as the replacement expiratory volume as a percentage of the expected value. Results the weight of patients in CPAP treatment group after treatment was significantly focused on the same group before treatment P0.05 BMI, neck circumference. The waist circumference was significantly larger than that in the same group before treatment (P = 0.05). The weight loss group and the combined treatment group were significantly lighter than the same group before treatment P value of 0.05 ~ 0.01U BMI-neck circumference. The waist circumference was significantly lower than that in the same group before treatment (P < 0.05). The difference of body weight, BMI and neck circumference of patients in the combined treatment group before and after treatment. The difference of waist circumference was significantly higher than that of weight loss treatment group (P < 0.01). The LAT of group A was significantly shorter than that of group A (P = 0.01). AHI was significantly lower than that in the same group before treatment (P < 0.01). All of them were significantly higher than those in the same group before treatment (P < 0.01). The difference of LAT before and after treatment in the combined treatment group was significant. The difference of LS_aO_2 was significantly higher than that of the other two groups (P < 0.01). The ERV% and FVC% of the patients in the treatment group were significantly lower than those in the same group (P < 0.01). ERV% and FVC% in weight loss group and combined treatment group were significantly higher than those in the same group before treatment (P < 0.01). ERV% difference and FVC% difference were significantly higher in combined treatment group than in weight loss treatment group (P < 0.01). Conclusion the patients with OSAHS and obesity were treated with CPAP at the same time. You should also receive weight loss treatment to a certain extent.
【作者單位】： 青島市市立醫(yī)院東院區(qū)呼吸內(nèi)科;青島市市立醫(yī)院東院區(qū)心內(nèi)科;
【基金】：國家自然科學(xué)基金項(xiàng)目資助(81400024)
【分類號(hào)】：R589.2;R766
【正文快照】： 隨著人們生活水平的提高,肥胖的發(fā)生率逐漸升高。有數(shù)據(jù)表明,全球?qū)⒂?億人口達(dá)到肥胖標(biāo)準(zhǔn)(BMI≥25kg/m2)[1],肥胖已經(jīng)逐漸成為全球威脅人類健康的最常見代謝疾病之一。肥胖不僅與心血管疾病、高凝狀態(tài)、腫瘤相關(guān),還與阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)相關(guān)。OSAHS是一種，

本文編號(hào)：1440292