乙酰半胱氨酸泡腾片联合双水平无创正压通气呼吸机治疗阻塞性睡眠呼吸暂停综合征患者的临床观察

目的:探讨乙酰半胱氨酸泡腾片联合双水平无创正压通气(BiPAP)呼吸机治疗阻塞性睡眠呼吸暂停综合征(OSAHS)患者的临床疗效。方法:平行开放的方法选取我院2010年9月-2013年9月OSAHS 患者180例,随机分为乙酰半胱氨酸泡腾片联合BiPAP呼吸机治疗组45例(A组)、单用乙酰半胱氨酸泡腾片组45例(B组)、单用BiPAP呼吸机治疗组45例(C组)和常规治疗组45例(D组);观察记录入院时及治疗12周结束时所有患者测身高、体质量、腰围,并计算体重指数(BMI)、腰臀比(WHR)。清晨空腹取静脉血测胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、尿酸、血糖、炎性因子(IL-6,TNF-α)、氧化/抗氧化指标(SOD)、多导睡眠监测PSG(AHI、LSpO₂)和 生存质量测定简表(WHOQOL-BREF中文版)等方面有无差异。结果:(1)4组治疗前、后BMI、WHR、TC、LDL-C、TG、尿酸、血糖、炎性因子(IL-6,TNF-α)、氧化/抗氧化指标(SOD)有显著差异性(P < 0.05);而且各组治疗后BMI、WHR、TC、LDL-C、TG、临床症状、炎性因子(IL-6,TNF-α)、氧化/抗氧化指标(SOD)等有显著差异性(P<0.05);其中A组下降幅度明显高于B组和C组。(2) 4组治疗前、后多导睡眠检测图仪PSG(AHI、LSpO₂)和 生存质量测定简表(WHOQOL-BREF中文版)有显著差异性(P < 0.05);而且各组治疗后多导睡眠监测有显著差异性(P<0.05);其中A组LSpO₂上升幅度明显高于B组和C组, AHI下降幅度明显高于B组和C组。结论:OSAHS患者总体生存质量较差,应从主要影响因素出发,提供合理、有效的干预措施,提高患者的生存质量;乙酰半胱氨酸片联合双水平无创呼吸机治疗OSAHS有较好的临床疗效,在呼吸科领域具有广泛的应用前景,值得临床推广。

Clinical observation of acetylcysteine effervescent tablets combined with BiPAP in treatment of obstructive sleep apnea hyperpnoea syndrome

OBJECTIVE To evaluate the clinical efficacy of acetylcysteine effervescent tablets combined with BiPAP in treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS 180 OSAHS patients were selected by using a open parallel method from our hospital from September 2010 to September 2013, and divided into four groups randomly: acetylcysteine effervescent tablets combined with BiPAP group(group A), only acetylcysteine antioxidant group (group B), only BiPAP hypopnea group (group C) and routine therapy group (group D). On admission and at the end of treatment of 12 weeks, all patients were observed and measured their height, weight, waist circumference, body mass index (BMI) and waist-hip ratio (WHR). Morning fasting venous blood was collected to determine cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), uric acid, glucose, IL-6, TNF-α, SOD, polysomnography PSG (AHI, LSpO₂), and the World Health Organization Quality of Life summary table (WHOQOL-BREF Chinese version) was used to compare the differences between groups. RESULTS BMI, WHR, TC, LDL-C, TG, uric acid, glucose, IL-6, TNF-α, SOD were significantly different before and after treatment in the four groups (P<0.05); in each group, BMI, WHR, TC, LDL-C, TG, clinical symptoms, IL-6, TNF-α, SOD were significantly different before and after treatment (P<0.05); decreases in group A were more significant than in group B and group C. In all four groups before and after treatment, polysomnography plotter PSG (AHI, LSpO₂) and the World Health Organization Quality of Life summary table (WHOQOL-BREF Chinese version) had significant differences (P<0.05); after treatment, polysomnography in each group had significant differences (P<0.05); LSpO₂ rise in group A was significantly higher than in group B and group C, AHI decline in group A was significantly higher than in group B and group C.CONCLUSION Overall survival quality in patients with OSAHS has poor quality, and it should start from the main factors to provide reasonable and effective interventions to improve the quality of life in patients; Acetylcysteine effervescent tablets combined with BiPAP has good clinical efficacy, and extensive application prospective in the field of respiratory diseases.