本文選題：阻塞性睡眠呼吸暫停綜合征 + 持續(xù)氣道正壓通氣��； 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的 系統(tǒng)評價持續(xù)氣道正壓通氣(CPAP)治療阻塞性睡眠呼吸暫停綜合征(OSAS)在改善血脂水平方面療效。 方法 計算機(jī)檢索PubMed, Embase, Springer Link, CNKI,萬方數(shù)據(jù)庫和google學(xué)術(shù)搜索引擎2000.01-2011.12公開發(fā)表的CPAP治療OSAS患者血漿脂類水平影響的隨機(jī)對照試驗(RCT)及非隨機(jī)對照研究,并查找相關(guān)會議文獻(xiàn)及詢問本領(lǐng)域?qū)＜耀@取資料；并按納入排除標(biāo)準(zhǔn)獨立篩選試驗、提取資料和評價方法學(xué)質(zhì)量,而后采用RevMan5.0軟件進(jìn)行Meta分析。 結(jié)果 共納入14項研究(見表1)。 1.CPAP治療前后的各指標(biāo)的結(jié)果：CPAP治療后TC值降低明顯[WMD=0.1968,95%CI(0.0752,0.3184)]；TG較前無明顯降低,Z=0.65(P=0.51),[WMD=0.0375,95%CI(0.0752,0.3184)]；HDL較治療前升高不明顯,Z=1.28(P=0.20),[WMD=0.0498,95%CI(-0.1263,0.0267)]；LDL值較前降低明顯[WMD=0.1847,95%CI(0.0481,0.3213)]。 2.平行試驗中各指標(biāo)的結(jié)果：CPAP治療后治療組TC值降低明顯[WMD=-0.18,95%CI(-0.37,0.00)]；TG較前無明顯降低,Z=0.05(P=0.96),[WMD=0.00,95%CI(-0.13,0.13)]；HDL較治療前升高不明顯,Z=1.23(P=0.22),[WMD=0.04,95%CI(-0.03,0.11)]；LDL值較前降低明顯[WMD=-0.22,95%CI(-0.43,-0.01)]。 3.交叉試驗中各指標(biāo)的結(jié)果：CPAP治療后治療組TC值降低明顯[WMD=-0.25,95%CI(-0.42,-0.09)]；TG較前明顯降低,[WMD=-0.19,95%CI(-0.40,0.03)]；HDL較治療前變化不明顯,Z=1.01(P=0.31),[WMD=-0.03,95%CI(-0.08,0.03)]；LDL值較前降低不明顯,Z=1.10(P=0.27),[WMD=-0.10,95%CI(-0.27,-0.08)]。 結(jié)論 本研究提示CPAP作為針對中重度OSAS患者的首選治療方法,在消除呼吸暫停、低通氣、鼾聲和呼吸努力相關(guān)微覺醒,改善睡眠狀態(tài)的同時,可調(diào)節(jié)血脂代謝,糾正患者的脂類代謝的紊亂,明顯降低TC水平。CPAP對TG、HDL、LDL等水平的影響尚待臨床進(jìn)一步證實。
[Abstract]:Purpose

To evaluate the efficacy of continuous positive airway pressure ventilation ( CPAP ) in the treatment of obstructive sleep apnea syndrome ( obstructive sleep apnea syndrome ) in the improvement of blood lipid levels .

method

Computers were searched for randomized controlled trials ( RCTs ) and non - randomized controlled studies of the effects of CPAP on plasma lipid levels in patients with obstructive sleep apnea , published by the published CPAP , Embase , Springer Link , CNKI , Wanfang database , and Google Academic Search Engine , 2000 . 01 - 2011 . 12 .
The independent screening test , extraction data and evaluation methodology quality were carried out according to the exclusion criteria , and the meta - analysis was carried out using the RevMan5.0 software .

Results

A total of 14 studies were included ( see table 1 ) .

1 . Results of the indexes before and after CPAP : the decrease of TC value after CPAP therapy decreased significantly ( WMD = 0 . 1968 , 95 % CI ( 0 . 0752 , 0 . 3184 ) ;
There was no significant decrease in TG , Z = 0.65 ( P = 0.51 ) , WMD = 0.0375 , 95 % CI ( 0.052 , 0.3184 ) ;
HDL was not significantly higher before treatment , Z = 1.28 ( P = 0.20 ) , WMD = 0.098 , 95 % CI ( - 0.1263 , 0.0267 ) ;
LDL value was significantly lower than that before , WMD = 0 . 1847 , 95 % CI ( 0 . 0481 , 0 . 3213 ) .

2 . Results of each index in the parallel test : the TC value of the treatment group after CPAP decreased significantly ( WMD = - 0.18 , 95 % CI ( - 0.37 , 0.00 ) ;
There was no significant decrease in TG , Z = 0.05 ( P = 0.96 ) , WMD = 0.00 , 95 % CI ( - 0.13 , 0.13 ) ;
HDL was not significantly higher before treatment , Z = 1.23 ( P = 0.22 ) , WMD = 0.04 , 95 % CI ( - 0.03 , 0.11 ) ;
LDL value was significantly higher than that before , WMD = - 0.22 , 95 % CI ( - 0.43 , - 0.01 ) .

3 . Results : TC value of treatment group decreased significantly after CPAP treatment , WMD = - 0.25 , 95 % CI ( - 0.42 , - 0.09 ) ;
TG was significantly lower than that before , WMD = - 0.19 , 95 % CI ( - 0.40 , 0.03 ) ;
HDL was not significant before treatment , Z = 1.01 ( P = 0.31 ) , WMD = - 0.03 , 95 % CI ( - 0.08 , 0.03 ) ;
LDL was not significantly lower than before , Z = 1.10 ( P = 0.27 ) , WMD = - 0.10 , 95 % CI ( - 0.27 , - 0.08 ) .

Conclusion

The present study suggested CPAP as the preferred treatment method for patients with moderate and severe obstructive sleep apnea syndrome . The effects of CPAP on the levels of TG , HDL , LDL and so on in patients with moderate and severe obstructive sleep apnea , hypoventilation , snoring and respiratory effort can be adjusted , and the level of TC can be significantly reduced . The effects of CPAP on TG , HDL , LDL and so on are still to be confirmed clinically .

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R766.4

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