摘要
目的:评价莫达非尼联合双水平气道正压通气(BiPAP)在治疗慢性阻塞性肺疾病(COPD)合并睡眠呼吸暂停综合征(OSAS)的临床疗效。方法:选取在医院接受治疗的93例COPD合并OSAS患者,根据治疗方案的不同将其分为对照组(41例)和观察组(52例),对照组采用常规药物联合BiPAP治疗;观察组在对照组的基础上口服莫达非尼。记录两组正压通气时间及不良反应情况,比较两组治疗前后血氧分压(PaO_(2))、血二氧化碳分压(PaCO_(2))、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1与FVC的比值(FEV1/FVC)、呼吸暂停指数(AHI)、总睡眠时间、最低氧饱和度和Epworth睡眠量表(ESS)评分的改善情况。结果:对照组和观察组患者治疗后的AHI、总睡眠时间、最低氧饱和度及ESS评分均较治疗前有显著改善,差异有统计学意义(t_(对照组)=21.187,t=6.155,t=7.648,t=29.947;t_(观察组)=22.380,t=7.931,t=8.168,t=37.593;P<0.05),观察组患者总睡眠时间及ESS评分均显著低于对照组,差异有统计学意义(t=2.315,t=14.232;P<0.05)。对照组和观察组患者治疗后1周和4周与治疗前相比,PaO_(2)有显著升高,Pa CO_(2)则有明显降低,差异有统计学意义(F对照组=29.947,F=36.147;F_(观察组)=27.533,F=34.580;P<0.05),而两组比较差异无统计学意义。对照组和观察组患者治疗后1周和4周的FVC、FEV1及FEV1/FVC通气指标均较治疗前有显著改善(F对照组=16.506,F=40.570,F=59.220;F_(观察组)=19.680,F=43.962,F=61.728;P<0.05),而两组比较差异无统计学意义。观察组和对照组不良反应发生率分别为19.2%(10/52)和7.3%(3/41),而两组比较差异无统计学意义。结论:对于COPD合并OSAS患者,呼吸机BiPAP模式可显著改善肺功能及肺通气相关指标,莫达非尼能提升睡眠质量,减轻白天的嗜睡症状,且未出现明显不良反应。
Objective:To evaluate the clinical efficacy of Modafinil combined with bi-level positive airway pressure(BiPAP)in treating chronic obstructive pulmonary disease(COPD)with obstructive sleep apnea syndrome(OSAS).Methods:A total of 93 patients with COPD combined with OSAS received treatment in hospital were enrolled in this study.They were divided into control group(41 cases)and observation group(52 cases)according to different treatment schemes.The control group was treated with conventional drugs combined with BiPAP and the observation group took Modafinil orally on the basis of control group.The ventilation time and the occurrence of adverse events of two groups were recorded,and the improved conditions of series indicators included partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide of blood(PaCO_(2)),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),the ratio of FEV1 to FVC,apnea hypopnea index(AHI),total sleep time(TST),the minimum arterial oxygen saturation(SaO_(2))and Epworth sleepiness scale(ESS)of two groups between pre and post treatment were compared.Results:The AHI,TST,the minimum SaO_(2) and ESS scores of two groups after treatment were significantly better than those before treatment(tcontrol group=21.187,t=6.155,t=7.648,t=29.947,tobservation group=22.380,t=7.931,t=8.168,t=37.593,P<0.05).And the TST and ESS score in observation group were significantly lower than those in control group(t=2.315,t=14.232,P<0.05).PaO_(2) of control group and observation group at the 1 th week and the 4 th week after treatment was significantly higher than that before treatment,while PaCO_(2) of two groups at same two time points after treatment was significantly lower than that before treatment(Fcontrol group=29.947,F=36.147,Fobservation group=27.533,F=34.580,P<0.05),respectively,there was no significant difference at the two indicators between the two groups.And the series of ventilation indexes included FVC,FEV1,FEV1/FVC in the two groups at the 1 th week and the 4 th week
作者
王亮
杨超
李玉静
郭贝贝
孟静
WANG Liang;YANG Chao;LI Yu-jing(Respiratory Department,Hebei Chest Hospital,Shijiazhuang 050041,China)
出处
《中国医学装备》
2021年第4期105-109,共5页
China Medical Equipment
基金
河北省科技厅科技计划(18277767D)“双水平正压通气在重叠综合征(OS)患者治疗中临床疗效分析”。
