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目的探讨持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并高血压患者血压及血脂代谢的影响。方法选取2014年11月—2016年12月深圳市龙岗区人民医院收治的OSAHS并高血压患者82例,采用随机数字表法分为对照组和观察组,每组41例。对照组患者给予常规治疗,观察组患者在常规治疗基础上联合应用持续气道正压通气治疗;两组患者均连续治疗2个月。比较两组患者治疗前后爱泼沃斯嗜睡量表(ESS)评分、血压[包括收缩压、舒张压]、血脂指标[包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、简明健康状况调查量表(SF-36)评分。结果治疗前两组患者ESS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者ESS评分低于对照组(P<0.05)。治疗前两组患者收缩压、舒张压比较,差异无统计学意义(P>0.05);治疗后观察组患者收缩压、舒张压低于对照组(P<0.05)。治疗前两组患者血清TC、TG、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清TC、TG、LDL-C水平低于对照组,血清HDL-C水平高于对照组(P<0.05)。治疗前两组患者生理功能、社会功能、精神状态、情感职能评分比较,差异无统计学意义(P>0.05);治疗后观察组患者生理功能、社会功能、精神状态、情感职能评分高于对照组(P<0.05)。结论持续气道正压通气可有效降低OSAHS并高血压患者血压,改善患者血脂代谢及嗜睡情况,提高患者生活质量。
Objective To investigate the effects of continuous positive airway pressure on blood pressure and blood lipid metabolism in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension. Methods Eighty-two OSAHS patients with hypertension were selected from November 2014 to December 2016 in Longgang District People’s Hospital of Shenzhen City, and divided into control group and observation group with 41 cases in each group by random number table. Patients in the control group were given routine treatment. Patients in the observation group were treated with continuous positive airway pressure ventilation on the basis of routine treatment. Patients in both groups were treated continuously for 2 months. Before and after treatment, the Epworth Sleepiness Scale (ESS) score, blood pressure [including systolic and diastolic blood pressure], blood lipid indicators [including total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] and the Concise Health Survey Scale (SF-36). Results There was no significant difference in ESS score between the two groups before treatment (P> 0.05). After treatment, the ESS score of the observation group was lower than that of the control group (P <0.05). The systolic blood pressure and diastolic blood pressure of the two groups before treatment were no significant difference (P> 0.05). After treatment, systolic blood pressure and diastolic blood pressure of the observation group were lower than those of the control group (P <0.05). There was no significant difference in serum TC, TG, LDL-C and HDL-C levels between the two groups before treatment (P> 0.05). After treatment, the levels of TC, TG and LDL-C in the observation group were lower than those in the control group Serum HDL-C levels higher than the control group (P <0.05). There was no significant difference in physiological function, social function, mental status and emotional function score between the two groups before treatment (P> 0.05). After treatment, the scores of physiological function, social function, mental status and emotional function in observation group were higher than those in control Group (P <0.05). Conclusion Continuous positive airway pressure ventilation can effectively reduce the blood pressure in patients with OSAHS and hypertension, improve blood lipid metabolism and lethargy in patients, and improve the quality of life of patients.