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目的了解睡眠呼吸暂停低通气综合征(SAHS)的自然病程;动态观察经鼻持续气道正压通气(nCPAP)治疗SAHS的长期疗效,评价其依从性好坏对SAHS患者呼吸暂停程度、血压、白天症状的影响。方法对依从性好组、依从性差组、未治疗组(各30例)分别进行治疗前后各指标的动态观察及比较,包括多导睡眠监测、睡前及醒后血压、体重指数、Epworth嗜睡评分。结果依从性好组患者经nCPAP治疗后其暂停低通气指数(AH I)由(61.5±12.7)次/h下降至(41.8±18.5)次/h(P<0.001),最低血氧饱和度(LSaO2)由(58.8±16.3)%上升至(78.5±12.2)%(P<0.001),ESS评分优于依从性差组和未治疗组,睡前及醒后收缩压及舒张压均明显降低,依从性差组的患者病情稳定,未治疗组的患者病情有不同程度的加重。结论依从性好组的患者复查时AH、ILSaO2、睡前及醒后收缩压及舒张压均明显好转,ESS评分优于未治疗组;长期CPAP治疗依从性好坏直接影响SAHS的病情进展及转归。
Objective To understand the natural history of sleep apnea-hypopnea syndrome (SAHS) and to observe the long-term efficacy of nasal continuous positive airway pressure (nCPAP) in the treatment of SAHS. To evaluate the compliance of apnea-hypopnea syndrome (SAHS) The effect of daytime symptoms. Methods The dynamic changes of each index before and after treatment were compared among the good compliance group, the poor compliance group, and the untreated group (30 cases each), including polysomnography, bedtime and wakefulness, body mass index, Epworth sleepiness score . Results In the good compliance group, the AHI decreased from (61.5 ± 12.7) times / h to (41.8 ± 18.5) times / h (P <0.001) and the lowest oxygen saturation LSaO2 increased from (58.8 ± 16.3)% to (78.5 ± 12.2)% (P <0.001). The ESS score was superior to those of poorly-treated and untreated patients. Systolic and diastolic blood pressure were significantly lower before and after awake Patients in the poor group were in stable condition, and patients in the untreated group had different degrees of aggravation. Conclusions AH, IL-1alpha, IL-2alpha, pre-natal and post-natal systolic and diastolic blood pressure were significantly improved in patients with good compliance and ESS scores were better than those in untreated patients. Long-term compliance with CPAP treatment directly affected the progress of SAHS Return