莫达非尼联合BiPAP呼吸机治疗慢性阻塞性肺疾病合并睡眠呼吸暂停综合征的临床疗效

目的:评价莫达非尼联合双水平气道正压通气(BiPAP)在治疗慢性阻塞性肺疾病(COPD)合并睡眠呼吸暂停综合征(OSAS)的临床疗效.方法:选取在医院接受治疗的93例COPD合并OSAS患者,根据治疗方案的不同将其分为对照组(41例)和观察组(52例),对照组采用常规药物联合BiPAP治疗;观察组在对照组的基础上口服莫...

Clinical efficacy of Modafinil combined with BiPAP ventilator in treating COPD with OSAS

Objective:To evaluate the clinical efficacy of Modafinil combined with bi-level positive airway pressure(BiPAP)in treating chronic obstructive pulmonary disease(COPD)with obstructive sleep apnea syndrome(OSAS).Methods:A total of 93 patients with COPD combined with OSAS received treatment in hospital were enrolled in this study.They were divided into control group(41 cases)and observation group(52 cases)according to different treatment schemes.The control group was treated with conventional drugs combined with BiPAP and the observation group took Modafinil orally on the basis of control group.The ventilation time and the occurrence of adverse events of two groups were recorded,and the improved conditions of series indicators included partial pressure of blood oxygen(PaO₂),partial pressure of carbon dioxide of blood(PaCO₂),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),the ratio of FEV1 to FVC,apnea hypopnea index(AHI),total sleep time(TST),the minimum arterial oxygen saturation(SaO₂)and Epworth sleepiness scale(ESS)of two groups between pre and post treatment were compared.Results:The AHI,TST,the minimum SaO₂ and ESS scores of two groups after treatment were significantly better than those before treatment(tcontrol group=21.187,t=6.155,t=7.648,t=29.947,tobservation group=22.380,t=7.931,t=8.168,t=37.593,P<0.05).And the TST and ESS score in observation group were significantly lower than those in control group(t=2.315,t=14.232,P<0.05).PaO₂ of control group and observation group at the 1 th week and the 4 th week after treatment was significantly higher than that before treatment,while PaCO₂ of two groups at same two time points after treatment was significantly lower than that before treatment(Fcontrol group=29.947,F=36.147,Fobservation group=27.533,F=34.580,P<0.05),respectively,there was no significant difference at the two indicators between the two groups.And the series of ventilation indexes included FVC,FEV1,FEV1/FVC in the two groups at the 1 th week and the 4 th week after treatment were significantly better than those before treatment(Econtrol group=16.506,F=40.570,F=59.220,Fobservation group=19.680,F=43.962,F=61.728,P<0.05),while there were no significant difference in these indicators between the two groups.The incidence of adverse reactions was 19.2%(10/52)in observation group and that was 7.3%(3/41)in control group,the difference of that between two groups was no significant.Conclusion:For patients with COPD combined with OSAS,the BiPAP mode of ventilator can significantly improve the lung function and pulmonary ventilation-related indicators.Modafinil can improve sleep quality and reduce daytime sleepiness symptoms,and there is no significantly adverse reactions.