摘要
目的探讨经鼻持续气道正压通气(nCPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAS)患者血压节律和胰岛素抵抗的影响。方法随机抽取中重度OSAS合并高血压患者62例,分为nCPAP治疗组(32例)与应用常规药物治疗对照组(30例),观察治疗前与治疗后2组患者多导睡眠图(PSG)参数、动态血压、空腹血糖、空腹血浆胰岛素以及胰岛素敏感性指数等多项指标的变化。结果在nCPAP治疗组,与治疗前比较,nCPAP治疗后患者PSG参数明显改善(P<0.01),血压明显下降(P<0.01),动态血压昼夜节律消失发生率明显下降(78.1%vs28.1%,P<0.01);治疗后3个月时胰岛素敏感性指数明显提高(0.019±0.008vs0.015±0.006,P<0.01)。对照组上述参数治疗前后均无变化。结论nCPAP治疗OSAS,不但可以纠正患者的呼吸暂停,改善临床症状,而且可以降低患者的血压,改善患者血压昼夜节律,提高患者血浆胰岛素敏感性,有助于降低心血管疾病的发病风险,预防糖尿病的发生。
Objective To analyze the effect of nasal continuous positive airway pressure （nCPAP） treatment on blood pressure rhythm and insulin resistance in patients with obstructive sleep apnea syndrome （OSAS） combined with hypertension. Methods Sixty-two patients with moderate/severe OSAS combined with hypertension were randomly selected and were divided into two groups ： nCPAP treatment group （ n = 32） and routine treatment control group （n = 30）. Polysomnography （PSG） monitoring parameters, ambulatory blood pressure, fast plasma glucose, fast plasma insulin, insulin sensitivity index （ISI） and other related indexes were observed before and after treatment. Results In nCPAP treatment group,compared with the pre-treatment values,the PSG parameters were obviously improved （all P 〈0. 01 ） ;the levels of blood pressure obviously fell （ P 〈 0. 01 ） and the rate of blood pressure day-nectumal rhythm disappea was decreased after treatment （78. 1% vs 28. 1%, P 〈0. 01 ）. ISI was obviously upgraded in treatment group after having been treated by nCPAP for three months（ 0. 019 ± 0. 008 vs 0. 015 ± 0. 006 ,P 〈 0. 01 ）. In control group, the parameters showed no significant difference between pre- and post-treatment. Conclusions The nCPAP treatment can not only improve clinical symptoms of OSAS but also lower levels of blood pressure, improve blood pressure rhythm , raise insulin sensitivity, and so it can cut down the incidence of cardiovascular disease and prevent diabetes mellitus.
出处
《中国厂矿医学》
2009年第5期518-520,共3页
Chinese Medicine of Factory and Mine
