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目的探讨持续正压通气(CPAP)对癫合并睡眠呼吸暂停综合征(OSA)患者癫发作频率的影响。方法 42例癫合并OSA患者根据是否能够耐受呼吸机分为持续正压通气(CPAP)组20例和药物组22例,CPAP组给予CPAP加抗癫药物治疗,药物组给予抗癫药物治疗,比较2组治疗前与治疗4周和24周时的癫发作频率和呼吸暂停低通气指数(AHI)。结果 2组治疗前癫发作频率和AHI差异无统计学意义(均P>0.05),CPAP组在治疗后4周和24周较治疗前发作频率明显减少(P<0.01),而药物组在治疗后4周和24周较治疗前发作频率无明显减少(P>0.05),治疗后4周和24周时,CPAP组的癫发作频率明显低于药物组(P<0.01),治疗24周后,CPAP组的AHI明显下降(P<0.01),而药物组AHI无变化(P>0.05)。结论 CPAP治疗癫合并OSA患者,短期和长期均能明显减少癫发作。
Objective To investigate the effect of continuous positive pressure ventilation (CPAP) on epileptic seizure frequency in patients with epilepsy and sleep apnea syndrome (OSA). Methods Forty-two patients with epilepsy and OSA were divided into two groups according to whether they were able to tolerate ventilator: CPAP group (n = 20) and drug group (n = 22). CPAP group was given CPAP plus antiepileptic drugs, antiepileptic drugs Epileptic seizure frequency and apnea hypopnea index (AHI) were compared between the two groups before treatment and at 4 and 24 weeks of treatment. Results There was no significant difference in the frequency of epileptic seizure and AHI between the two groups before treatment (all P> 0.05). The frequency of seizure decreased significantly in CPAP group 4 weeks and 24 weeks after treatment (P <0.01) The frequency of seizure in CPAP group was significantly lower than that in the drug group at 4 weeks and 24 weeks after treatment (P <0.01). After 24 weeks of treatment , AHI in CPAP group was significantly decreased (P <0.01), while there was no change in AHI in drug group (P> 0.05). Conclusion CPAP treatment of epileptic patients with OSA, both short-term and long-term can significantly reduce epileptic seizures.