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目的探究双水平气道正压通气(Bi PAP)对阻塞性睡眠呼吸暂停低通气综合征合并慢性阻塞性肺疾病(OSAHS-COPD)患者心肺、血管内皮功能以及近期心肺事件的影响。方法选取75例OSAHSCOPD患者随机分为观察组即Bi PAP治疗组38例和对照组常规治疗组37例。两组患者均接受常规治疗,观察组给予Bi PAP治疗,每晚4 h。分别观察两组治疗前、治疗后6个月心肺功能(BNP、右室Tei指数、左室Tei指数、LVEF、肺动脉压、FEV1/FVC、FEV1占预计值%)及血管内皮功能(内皮素-1、NO)的变化,并随访患者的近期心肺事件。结果观察组治疗6个月后BNP及Tei指数较同组治疗前有明显下降(P<0.05);肺功能(FEV1/FVC、FEV1占预计值%)以及血管内皮功能(内皮素-1、NO)比同组治疗前有明显改善(P<0.05);观察组治疗6个月后BNP以及Tei指数较对照组治疗6个月后有明显下降(P<0.05),肺功能以及血管内皮功能有明显改善(P<0.05)。观察组近期心肺事件发生率(50.00%)明显低于常规治疗组(75.00%)(P<0.05)。结论 Bi PAP治疗可以改善OSAHS-COPD患者的心肺功能及血管内皮功能,改善患者的近期预后。
Objective To investigate the effects of bi-level positive airway pressure (Bi PAP) on cardiorespiratory, endothelial function and recent cardiopulmonary events in patients with obstructive sleep apnea-hypopnea syndrome and chronic obstructive pulmonary disease (OSAHS-COPD). Methods Seventy-five patients with OSAHSCOPD were randomly divided into observation group (38 cases) and control group (37 cases). Both groups were treated routinely, and the observation group was treated with Bi PAP at 4 h per night. Cardiac function (BNP, Tei index of right ventricle, Tei index of left ventricle, LVEF, pulmonary arterial pressure, FEV1 / FVC, the predicted value of FEV1) and vascular endothelial function (endothelin- 1, NO) changes, and follow-up of patients with recent cardiopulmonary events. Results The BNP and Tei index in the observation group decreased significantly (P <0.05) compared with those in the same group before treatment. The pulmonary function (FEV1 / FVC, FEV1 accounting for the predicted value) and the vascular endothelium function (endothelin- (P <0.05). Compared with the control group, BNP and Tei index of the observation group decreased significantly (P <0.05) after 6 months of treatment and lung function and endothelial function Significant improvement (P <0.05). The incidence of cardiopulmonary events in the observation group (50.00%) was significantly lower than that in the conventional treatment group (75.00%) (P <0.05). Conclusion Bi PAP treatment can improve the cardiopulmonary function and vascular endothelial function in patients with OSAHS-COPD and improve the prognosis of the patients.