无创呼吸机对阻塞性睡眠呼吸暂停低通气综合征血清炎症因子及颈动脉斑块风险的影响

目的研究无创呼吸机对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)血清炎症因子及颈动脉斑块风险的影响。方法选取2018年9月到2019年9月我院收治的中重度OSAHS患者90例作为研究对象,使用抽签方式将其随机分为治疗组和对照组,每组45例,对照组采取常规内科治疗,治疗组在对照组的基础上采取无创呼吸机治疗,疗程12周,比较两组治疗前后睡眠监测结果呼吸暂停低通气指数(AHI)、氧减指数(ODI)、最低血氧饱和度(LSpO;)、Epworth嗜睡量表(ESS)]、血清炎症因子肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)、白细胞介素-6(IL-6)]、颈动脉斑块形成情况斑块大小、斑块厚度、斑块数量、颈总动脉距分叉2cm处中层内膜厚度(IMT)]、同室伴侣Calgary睡眠呼吸暂停生活质量指数(SAQLI)。结果治疗组治疗后AHI、ODI、ESS显著较治疗前降低,且低于对照组,LSpO;较治疗前明显增高,且高于对照组,有显著差异(P<0.05)。治疗组治疗后TNF-α、ET-1、IL-6较治疗前显著降低,且低于对照组,有显著差异(P<0.05)。治疗组治疗后IMT较治疗前显著降低,且低于对照组,有显著差异(P<0.05)。治疗组治疗后日常功能、情感、症状评分较治疗前显著增高,且高于对照组,有显著差异(P<0.05)。结论无创呼吸机治疗能较好的改善OSAHS患者症状,提高患者夜间最低血氧饱和度,减轻其炎症因子水平及颈动脉斑块风险,促进患者及其同室伴侣生活质量的改善。

Effect of noninvasive ventilator on serum inflammatory factors and carotid plaque risk in obstructive sleep apnea hypopnea syndrome

Objective To study the effect of noninvasive ventilator on serum inflammatory factors and carotid plaque risk in obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From September 2018 to September 2019, 90 patients with moderate or severe OSAHS admitted to our hospital were randomly divided into the treatment group and the control group, with 45 cases in each group. The control group was treated with conventional internal medicine, while the treatment group was treated with non-invasive ventilator on the basis of the control group, with a course of 12 weeks. The results of sleep monitoring(AHI, ODI, LSpO;, ESS), serum inflammatory factors(TNF-α, ET-1, IL-6), carotid plaque formation(plaque size, plaque thickness, plaque thickness) were compared between the two groups before and after treatment. The number of blocks, intima-media thickness(IMT) at 2 cm from the bifurcation of the common carotid artery, and Calgary sleep apnea quality of life index(saqli) were measured.Results After treatment, AHI, ODI, ESS in the treatment group were significantly lower than those before treatment, and lower than those in the control group. Lspo2 was significantly higher than that before treatment and higher than that in the control group(P<0.05). After treatment, TNF-α, ET-1 and IL-6 in the treatment group were significantly lower than those before treatment, and lower than those in the control group(P<0.05). After treatment, the IMT of the treatment group was significantly lower than that before treatment, and lower than that of the control group(P<0.05). After treatment, the scores of daily function, emotion and symptom in the treatment group were significantly higher than those before treatment, and higher than those in the control group(P<0.05).Conclusion Noninvasive ventilator therapy can improve the symptoms of OSAHS patients, improve the patient′s lowest oxygen saturation at night, reduce the level of inflammatory factors and the risk of carotid plaque, and improve the quality of life of patients and their roommates.