發(fā)布時間：2018-06-15 20:39

  本文選題：OSAHS + 高血壓　； 參考：《昆明理工大學(xué)》2017年碩士論文

【摘要】：OSAHS疾病嚴(yán)重影響著患者的睡眠質(zhì)量和生命健康,同時也造成了重大的社會經(jīng)濟(jì)、家庭幸福方面的不良影響。因此,CPAP治療效果的療效評價對臨床決策十分重要。利用具有能對同課題的諸多研究結(jié)果進(jìn)行綜合統(tǒng)一優(yōu)勢的Meta分析方法評價CPAP聯(lián)合常規(guī)降壓藥物對中國OSAHS合并高血壓患者的綜合療效,為國內(nèi)相關(guān)臨床醫(yī)生提供一種參考治療方法。方法計算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、Cochrane Library、PubMed、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI)、萬方資源數(shù)據(jù)庫,重慶維普網(wǎng)等電子數(shù)據(jù)庫并手工檢索相關(guān)期刊,查找CPAP治療對OSAHS合并高血壓患者綜合療效影響方面的臨床隨機(jī)對照試驗(RCT),對符合條件的RCT,逐個評價入選研究的質(zhì)量,提取納入文獻(xiàn)基本研究資料,選取RevMan5.3軟件為分析工具進(jìn)行Meta分析,以Meta分析中的合并效應(yīng)統(tǒng)計參數(shù)探討CPAP聯(lián)合常規(guī)降壓藥物的治療效果。共納入13篇文獻(xiàn)。Meta分析數(shù)據(jù)顯示:各項指標(biāo)差異均具有統(tǒng)計學(xué)意義[AHI:WMD=-25.19,95%CI(-34.05,-16.33),P0.00001;LSa02:WMD=17.57,95%CI(11.16,23.98),P0.00001;白天平均收縮壓:WMD=-8.26,95%CI(-11.18,-5.34),P0.00001;白天平均舒張壓:WMD=-6.42,95%CI(-8.25,-4.60),P0.00001;夜間平均收縮壓:WMD=-12.92,95%CI(-19.65,-6.19),P0.0002;夜間平均舒張壓:WMD=-6.31,95%CI(-8.53,-4.09),P0.00001;24h 平均收縮壓:WMD=-10.28,95%CI(-14.08,-6.48),P0.00001;24h 平均舒張壓:WMD=-6.99,95%CI(-8.88,-5.09),P0.00001;],提示CPAP聯(lián)合常規(guī)降壓藥物治療后OSAHS合并高血壓患者各項指標(biāo)改善程度較對照組(常規(guī)藥物治療)均有明顯提升。漏斗圖大致對稱,存在發(fā)表偏倚可能性很小。CPAP聯(lián)合常規(guī)降壓藥物治療對我國OSAHS合并高血壓患者有顯著的療效。為進(jìn)一步明確CPAP治療OSAHS合并難治性高血壓的降壓療效,以期更好地應(yīng)用于臨床,本課題針對以上問題再次做了 Meta分析。系統(tǒng)性的評價CPAP對OSAHS低通氣綜合癥OSAHS合并難治性高血壓患者血壓的影響。計算機(jī)檢索 ScienceDirect、Cochrane Library、PubMed、Web of Science等電子數(shù)據(jù)庫并手工檢索相關(guān)期刊,查找CPAP治療對OSAHS合并難治性高血壓患者血壓影響的臨床隨機(jī)對照試驗(RCT),對符合條件的RCT,逐一對納入研究的質(zhì)量進(jìn)行評價,提取納入文獻(xiàn)的基本研究資料,選取RevMan5.3和R 3.2.2軟件為分析工具進(jìn)行Meta分析。共納入7篇RCT研究。Meta分析結(jié)果顯示:CPAP治療后OSAHS合并難治性高血壓患者24h平均收縮壓/舒張壓,較對照組有顯著改善,差異具有統(tǒng)計學(xué)意義。24h平均收縮壓/舒張壓合并效應(yīng)統(tǒng)計結(jié)果分別為:[WMD=-5.36,95%CI(-8.60,-2.11),P=0.001;I270%]/[WMD=-4.21,95%CI(-6.39,-2.04),P=0.00001;I2 79%];CPAP 治療可有效地降低OSAHS合并難治性高血壓患者的血壓。以上兩項Meta分析,均表明CPAP治療OSAHS合并高血壓具有一定療效,并且在對國內(nèi)的OSAHS合并高血壓患者的效果更為顯著,而對于CPAP治療OSAHS合并難治性高血壓則提示配合常規(guī)降壓藥物治療效果將會更好。
[Abstract]:OSAHS disease seriously affects the patient's sleep quality and life health, but also has a great impact on social economy and family happiness. Therefore, the evaluation of therapeutic effect of CPAP is very important for clinical decision. To evaluate the comprehensive efficacy of CPAP combined with conventional antihypertensive drugs in OSAHS patients with hypertension in China, a meta-analysis method was used to evaluate the comprehensive advantages of the results of many studies on the same subject. To provide a reference treatment for the relevant clinicians in China. Methods the Chinese biomedical literature database (CBM), the Cochrane Library PubMeddatabase, the Chinese academic journal full-text database (CNKI), the Wanfang resource database and the Chongqing Weipu Web were searched by computer and the related journals were searched manually. To find out the effect of CPAP therapy on the comprehensive curative effect of OSAHS patients with hypertension, a randomized controlled trial was conducted to evaluate the quality of the selected studies one by one for the eligible RCTs, and to extract and incorporate the basic research materials into the literature. Revman 5.3 software was selected as a tool for meta-analysis. The combined effect of CPAP combined with conventional antihypertensive drugs was evaluated by the statistical parameters of combined effects in meta-analysis. 鍏辯撼鍏，

本文編號：2023556