本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 葡萄籽原花青素��； 參考：《實(shí)用預(yù)防醫(yī)學(xué)》2016年07期

【摘要】：目的觀察葡萄籽原花青素(grape seed proanthocyanidin extract,GSPE)對(duì)中老年阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者肺通氣及炎癥水平的影響。方法 2012年12月-2014年12月為華北理工大學(xué)附屬醫(yī)院呼吸內(nèi)科確診的108例中老年OSAHS患者隨機(jī)分為對(duì)照組(36例),GSPE A組(36例)與GSPE B(36例)。對(duì)照組給予持續(xù)氣道正壓通氣(CPAP)治療;GSPE A組和GSPE B組在此基礎(chǔ)上分別給予高劑量(100mg/粒,2粒/次)和低劑量(100 mg/粒,1粒/次)GSPE口服治療。在治療前和治療后8周檢測(cè)外周血白細(xì)胞介素-6(IL-6)和腫瘤壞死因子-α(TNF-α)水平,結(jié)合多導(dǎo)睡眠圖監(jiān)測(cè)(polysonmography,PSG)監(jiān)測(cè)最長(zhǎng)低通氣時(shí)間(the maximum hypopnea time,MHT)、低通氣指數(shù)(low ventilation index,HI)、最長(zhǎng)呼吸暫停時(shí)間(the longest apnea time,LAT)、呼吸暫停指數(shù)(apnea index,AI)和呼吸紊亂指數(shù)(respiratory disturbance index,RDI)、夜間最低血氧飽和度(lowest oxygen saturation,LSa O_2)。采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果治療前,三組基本臨床資料、PSG檢測(cè)指標(biāo)、血清IL-6、TNF-α水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);與治療前比較,對(duì)照組治療后的MHT、HI、LAT、AI和RDI、LSa O_2均顯著改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05);GSPE A組:治療后的MHT、HI、LAT、AI、RDI、LSa O_2較治療前顯著改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05);GSPE B組:治療后的MHT、HI、RDI、LSa O_2均較治療前顯著改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。LAT、AI雖有所改善,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后,GSPE A組和GSPE B組的MHT、HI、LAT、AI、RDI和LSa O_2的改善程度優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);GSPE A組MHT、HI、LAT、AI、RDI和LSa O_2的改善程度優(yōu)于對(duì)照組GSPE B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,GSPE A組和GSPE B組中IL-6(20.10±5.96和26.33±6.38 vs.33.14±7.22)、TNF-α(32.42±6.33和42.80±5.48 vs.51.32±4.28)低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);GSPE A組治療總有效率(88.2%)顯著高于對(duì)照組(70.5%)和GSPE B組(81.8%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 GSPE可有效的降低IL-6、TNF-α水平,提高中老年OSAHS患者的治療效果。
[Abstract]:Objective to observe the effects of grape seed procyanidin seed proanthocyanidin extract (GSPE) on pulmonary ventilation and inflammation in elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods from December 2012 to December 2014, 108 middle-aged and elderly patients with OSAHS were randomly divided into control group (n = 36) and GSPE group (n = 36). The control group was treated with continuous positive airway pressure ventilation (CPAP). On this basis, the GSPE group and the GSPE B group were treated with high dose of 100 mg / L and low dose of 100 mg / L of GSPE respectively. The levels of interleukin-6 (IL-6) and tumor necrosis factor- 偽 (TNF- 偽) in peripheral blood were measured before and 8 weeks after treatment. Polysomnography (PSG) was used to monitor the maximum hypopnea time of hypopnea, the hypopnea index, the longest apnea ventilation index, the longest apnea time, the apnea index, the respiratory disorder index, the respiratory disturbance index, and the lowest oxygen saturation at night. SPSS17.0 software was used for statistical analysis. Results before treatment, there was no significant difference in the levels of serum IL-6 and TNF- 偽 between the three groups before and after treatment, and there was no significant difference in the levels of serum IL-6 and TNF- 偽 between the control group and the control group after treatment, both MHT HIHI LATA AI and RDI LSa O 2 were significantly improved after treatment, and there was no significant difference in the level of IL-6 and TNF- 偽 between the three groups before and after treatment. There was significant difference in GSPE group (P 0.05): after treatment, there was a significant improvement in MHTHHIHI-LATA LSAO2 compared with that before treatment, and the difference was statistically significant. The difference was statistically significant (P 0.05): after treatment, the MHTHU HIRDILSAO _ 2 was significantly improved than that before treatment, and the difference was statistically significant (P 0.05) .LATA AI was improved, and there was no significant difference between the two groups, and the difference was significant (P 0.05), and the difference was significant (P < 0.05), and the difference was significant (P < 0.05). However, there was no significant difference between GSPA group and GSPE B group (P 0.05). The improvement of LSa O 2 and LSa O 2 in GSPA group and GSPE B group was better than that in control group. The difference was statistically significant. The improvement of LSa O 2 and LSa O 2 in GSPE A group was better than that in GSPE B group. After treatment, the IL-6(20.10 鹵5.96 and 26.33 鹵6.38 vs.33.14 鹵7.22 vs.33.14 of TNF- 偽 in the GSPA group and GSPE B group were significantly lower than those in the control group (32.42 鹵6.33 and 42.80 鹵5.48 vs.51.32 鹵4.28), and the total effective rate in the P0.05GSPE A group was significantly higher than that in the control group (70.5.5%) and in GSPE B group (81.8%). Conclusion GSPE can effectively reduce the level of IL-6 TNF- 偽 and improve the therapeutic effect of OSAHS.
【作者單位】： 華北理工大學(xué)附屬醫(yī)院呼吸內(nèi)科;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題(ZD20150515)
【分類(lèi)號(hào)】：R766

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