不同无创正压通气模式对我国COPD合并OSAHS患者疗效的Meta分析

目的:使用Meta分析评价双水平气道正压通气（BiPAP）与持续气道正压通气（CPAP）对我国慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征人群的治疗成效。方法:通过计算机检索中国知网(CNKI)、万方医学网数据库、维普中文科技期刊数据库(VIP)等中文数据库，检索时间从建库至2022年01月，提取相应资料后采用Rev Man5.4软件、Stata15.0软件进行Meta分析。结果:最终纳入11篇中文文献，800例患者。Meta分析结果显示：BiPAP较CPAP能更好地改善动脉血pH（MD=0.08，95％CI：0.06～0.10，P＜0.00001）,增加患者的动脉氧分压（MD=5.56，95％CI：2.04～9.08，P=0.002）,降低动脉二氧化碳分压（MD=-6.72，95％CI：-9.99～-3.46，P＜0.0001）,提高SpO2Low（MD=2.46，95％CI：1.24～3.68，P<0.0001）,改善AHI（MD=-4.14，95％CI：-6.35～-1.92，P=0.0003),缩短最长呼吸暂停时间（MD=-5.59，95％CI：-7.85～-3.32，P<0.00001）。纳入的11篇文章中，有3篇介绍了治疗的相关不良反应及死亡病例，BiPAP组腹胀（4例）、口鼻咽干燥（4例）、气胸（3例）、死亡病例（1例）；CPAP组腹胀（8例）、口鼻咽干燥（9例）、气胸（7例）、死亡病例（16例），差异有统计学意义。结论:相较于CPAP，BiPAP更利于缓解中国人群重叠综合征导致的呼吸窘迫，显著改善了动脉血气各指标、AHI、SpO2Low和最长呼吸暂停时间，除此之外，其死亡病例及不良反应均比CPAP组低，证实了其安全性与临床疗效。

The Efficacy of Different Non-invasive Positive Pressure Ventilation Patterns on the Treatment of COPD Combined with OSAHS in China: A Meta Analysis

Objective: To evaluate the efficacy of bi-level positive airway pressure (BiPAP) and continuous positive airway pressure (CPAP) on the group of chronic obstructive pulmonary disease combined with obstructive sleep apnea hypoventilation syndrome in China using Meta-analysis.Methods: Chinese Knowledge Resources database (CNKI), Wanfang Medical network database, Weip Chinese technology journal database (VIP)and other Chinese databases were searched by computer, from database construction to January,2022. After extracting the corresponding data, Meta analysis was analyzed using Rev Man5.4 software and Stata15.0 software.Results: 11 literature, 800 patients.The Meta-analysis showed that BiPAP improved the arterial blood pH better than CPAP (MD=0.08, 95%CI:0.06~0.10, P<0.00001), Increase the arterial oxygen partial pressure in the patient (MD=5.56, 95%CI:2.04~9.08, P=0.002), Reduce the arterial carbon dioxide partial pressure (MD= -6.72, 95%CI:-9.99~-3.46, P<0.0001), Improve the SpO2Low (MD=2.46, 95%CI:1.24~3.68, P<0.0001), Improve AHI (MD= -4.14, 95%CI:-6.35~-1.92, P=0.0003), Reduce the maximum apnea time (MD= -5.59, 95%CI:-7.85~-3.32, P<0.00001).Among the 11 articles included, 3 introduced the adverse reactions and deaths related to treatment, including abdominal distension (4), dry nasopharyngeal (4), pneumothorax (3) and death (1) in BiPAP; abdominal distension (8), dry nasopharyngeal (9), pneumothorax (7), and death (16) in CPAP.Conclusion: Compared with CPAP, BiPAP was better able to relieve respiratory distress in patients with overlapping syndrome in the Chinese population, and significantly improved the arterial blood gas index, AHI, SpO2Low and the longest apnea time. In addition, its deaths and adverse effects were lower than those in the CPAP group, confirming its safety and clinical efficacy.