本文關(guān)鍵詞： 殘余白天嗜睡 阻塞性睡眠呼吸暫停綜合征 持續(xù)氣道正壓通氣 莫達(dá)非尼　出處：《南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版)》2015年11期 　論文類型：期刊論文

【摘要】：目的 :評價莫達(dá)非尼治療阻塞性睡眠呼吸暫停綜合征(obstructive sleep apnea syndrome,OSAS)經(jīng)有效持續(xù)氣道正壓通氣(continuous positive airway pressure,CPAP)治療后仍殘余嗜睡的療效及安全性。方法:隨機選取自2014年7月—12月就診于南京醫(yī)科大學(xué)第一附屬醫(yī)院睡眠呼吸障礙中心,患有中重度OSAS且經(jīng)有效CPAP治療仍殘余白天嗜睡的32例男性患者,Epworth嗜睡量表(Epworth sleepiness scale,ESS)評分10分。研究包括3個階段:T1階段行基線檢測并將受試者隨機分配至莫達(dá)非尼組和安慰劑組;T2階段口服莫達(dá)非尼或安慰劑,每日1次,劑量為100 mg,共7 d;T3階段口服莫達(dá)非尼或安慰劑,每日1次,劑量為200 mg,共28 d,T3階段的最后1 d行最終評價。T1、T3階段的檢測指標(biāo)包括:血常規(guī)、血生化、尿常規(guī)、心電圖檢測,夜間多導(dǎo)睡眠監(jiān)測、多發(fā)小睡實驗,此外在T1、T2、T3階段持續(xù)檢測ESS。結(jié)果:藥物治療前后所有受試者呼吸暫停指數(shù)、CPAP每晚使用時間無明顯變化。藥物治療后,與安慰劑組比較,莫達(dá)非尼治療組平均入睡潛伏期延長、ESS評分下降,差異均有統(tǒng)計學(xué)意義(P均0.05);此外,在莫達(dá)非尼治療組中,T3(200 mg劑量)較T2(100 mg劑量),ESS下降更加顯著(F=0.719,P=0.015);莫達(dá)非尼治療組有62.5%患者出現(xiàn)口干、惡心、頭痛等不良反應(yīng),所有不良反應(yīng)均介于輕中度之間,差異無統(tǒng)計學(xué)意義(P=0.41)。結(jié)論:莫達(dá)非尼可以改善中重度OSAS患者經(jīng)有效CPAP治療仍殘余的白天嗜睡,患者對該藥具有良好的耐受性。
[Abstract]:Objective: to evaluate the effect of modafinil on obstructive sleep apnea syndrome in patients with obstructive sleep apnea syndrome (OSAS). OSAS) continuous positive airway pressure via effective continuous positive airway pressure (CPAP). Methods: from July 2014 to December, we randomly selected sleep apnea center of the first affiliated hospital of Nanjing Medical University. There were 32 male patients with moderate and severe OSAS who were treated with effective CPAP and remained daytime drowsiness. Epworth somnolence scale, Epworth sleepiness scale. The study consisted of three stages: T1: baseline test and randomized assignment to the modafenib group and the placebo group. T2-phase oral modafinil or placebo, once a day, at a dose of 100 mg for 7 days; In the T3 phase, modafinil or placebo was administered once a day at a dose of 200 mg, and the final evaluation was performed on the last day of the 28 d T 3 phase. The indicators of T3 stage included: blood routine, blood biochemistry, urine routine, electrocardiogram test, nocturnal polysomnography monitoring, multiple napping test, in addition to T1T 2. Results: there was no significant change in apnea index (CPAP) in all subjects before and after medication. The scores of ESS in the modafenib group were significantly lower than those in the control group (P < 0.05). In addition, in the modafenib treatment group, the dose of T3 + 200 mg) was significantly lower than that of T2 + 100mg / L, and the decrease of ESS was more significant than that of T2 + 100mg / kg. In the modafinil treatment group, 62.5% patients developed dry mouth, nausea, headache and other adverse reactions, all the adverse reactions were between mild and moderate. Conclusion: modafenib can improve daytime sleepiness in patients with moderate and severe OSAS after effective CPAP treatment, and the patients have good tolerance to the drug.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院呼吸內(nèi)科;南京醫(yī)科大學(xué)附屬無錫市人民醫(yī)院呼吸科;
【基金】：江蘇省科技創(chuàng)新與成果轉(zhuǎn)化專項基金(BL2012012)
【分類號】：R766
【正文快照】： 214043)南京醫(yī)科大學(xué)學(xué)報阻塞性睡眠呼吸暫停綜合征(obstructive sleepapnea syndrome,OSAS)是一種較常見的慢性疾病,以夜間反復(fù)發(fā)生的部分或完全上氣道塌陷為特點,引起低通氣和(或)呼吸暫停事件,導(dǎo)致睡眠過程中斷、間歇性缺氧及微覺醒的反復(fù)發(fā)生,從而引起夜間睡眠結(jié)構(gòu)紊亂、

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