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[1]任庆伟.持续气道正压通气、口腔矫治器和体育锻炼治疗阻塞性睡眠呼吸障碍低通气综合征的疗效比较[J].天津医科大学学报,2015,21(05):412-417.
 REN Qing-wei.Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training on obstructive sleep apnea hypopnea syndrome ?[J].Journal of Tianjin Medical University,2015,21(05):412-417.
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持续气道正压通气、口腔矫治器和体育锻炼治疗阻塞性睡眠呼吸障碍低通气综合征的疗效比较(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
21卷
期数:
2015年05期
页码:
412-417
栏目:
临床医学
出版日期:
2015-09-20

文章信息/Info

Title:
Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training on obstructive sleep apnea hypopnea syndrome

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文章编号:
1006-8147(2015)05-0412-06
作者:
任庆伟
(山东省东营市中国石化集团胜利石油管理局胜利医院呼吸科, 东营 257055)
Author(s):
REN Qing-wei
(Department of Respiratory Medicine,Victory Hospital of Victory Oil Field,Dongying 257055,China)
关键词:
阻塞性睡眠呼吸障碍低通气综合征持续气道正压通气口腔矫治器体育锻炼
Keywords:
obstructive sleep apnea hypopnea syndromecontinuous positive airway pressureoral applianceexercise training

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分类号:
R56
DOI:
-
文献标志码:
A
摘要:
目的:对比分析[1]持续气道正压通气(CPAP)、口腔矫治器(OA)和体育锻炼治疗阻塞性睡眠呼吸障碍低通气综合征(OSAHS)的疗效差别。方法:根据纳入/排除标准,选取OSAHS患者63例,随机分成CPAP治疗组(n = 19)、OA治疗组(n = 21)和体育锻炼组(n = 23)等3组,分别给予3个月的CPAP治疗、OA治疗或体育锻炼。对比分析患者治疗前后的多导睡眠图(PSG)监测结果,血液学指标检查和日间嗜睡评分量表(ESS)等的变化。结果:相比治疗前,CPAP组和OA组治疗3个月后的呼吸暂停低通气指数(AHI)明显降低(P<0.01),睡眠潜伏期缩短(P<0.05),觉醒时间缩短(P<0.05),微觉醒指数均降低(P<0.05),睡眠平均SpO2提高(P<0.05)。体育锻炼组患者锻炼后与锻炼前相比,ESS评分降低(P<0.05),其他指标锻炼前后的差异无统计学意义(P均>0.05)。但体育锻炼组患者血液相关指标变化明显,主要是白细胞降低,胆固醇降低,极低密度脂蛋白降低,甘油三酯降低等(P均<0.05)。结论:持续气道正压通气和口腔矫治器均可以降低呼吸暂停低通气指数等睡眠指标;体育锻炼仅能改善OSAHS患者的白日嗜睡症状和一些血液学指标,单独疗效不明显。

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Abstract:
Objective To compare the effects of continuous positive airway pressure (CPAP), oral appliance (OA) and exercise training for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods:Sixty-three patients with OSAHS and body mass indices less than 28 kg/m2 were randomly divided into 3 groups:CPAP (n = 19), OA (n = 21) and exercise training (n = 23). Polysomnography (PSG), blood samples and Epworth sleepiness scale (ESS) were obtained before and after 3 months of physical exercise or treatment with CPAP or OA. Results:After treatment with CPAP or an OA, the patients were presented with reductions in the apnea-hypopnea index (AHI), sleep latency, awakening time and arousal index, and increase in the average sleep SpO2. No changes in the sleep parameters were observed in the physical exercise group. However, this group was presented with reductions in the following parameters: white blood cell, cholesterol, very-low-density lipoprotein and triglycerides. Three months of exercise and training was found to have a positive efficacy on subjective daytime sleepiness of ESS. ConclusionCPAP and OA can reduce some sleepy indicators, such as apnea hypopnea index. Physical exercise and training, if achieved, could improve somnolence and blood indicators of the patients, but physical training alone is not sufficiently effective.

参考文献/References:

[1]Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults[J]. N Engl J Med, 1993, 328(17): 1230

[2]邱志辉,伍颖欣,严惠婵,等.不同年龄段睡眠呼吸暂停低通气患儿呼吸暂停的特点[J].中华医学杂志,2013,93(6):419

[3]丁秀和,庄莉,丁春华,等.阻塞性睡眠呼吸暂停低通气综合征患者尿微量白蛋白变化及其相关因素分析[J].中国医师进修杂志,2008,31(27):27

[4]中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].柳州医学,2012,35(3):162

[5]彭裕民.阻塞性睡眠呼吸暂停低通气综合征的诊断及治疗进展[J].临床肺科杂志,2012,17(5):902

[6]Kushida C A, Littner M R, Hirshkowitz M, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders[J]. Sleep, 2006, 29(3): 375.

[7]Barceló A, Piérola J, Esquinas C, et al. Relationship between aldosterone and the metabolic syndrome in patients with obstructive sleep apnea hypopnea syndrome: effect of continuous positive airway pressure treatment[J]. PLoS One, 2014, 9(1): e84362.

[8]韦璇,刘红,雷飞,等.阻塞性睡眠呼吸暂停患者持续气道正压通气治疗中复杂性睡眠呼吸暂停的发生及其特点[J].中华医学杂志,2013,93(26):2034

[9]Tuomilehto H, Gylling H, Peltonen M, et al. Sustained improvement in mild obstructive sleep apnea after a diet- and physical activity-based lifestyle intervention: postinterventional follow-up[J]. Am J Clin Nutr, 2010, 92(4): 688.

[10]Kline C E, Ewing G B, Burch J B, et al. Exercise training improves selected aspects of daytime functioning in adults with obstructive sleep apnea[J]. J Clin Sleep Med, 2012, 8(4): 357.

[11]Kline C E, Crowley E P, Ewing G B, et al. The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial[J]. Sleep, 2011, 34(12): 1631.

[12]Sleep-related breathing disorders in adults:recommendations for syndrome definition and measurement techniques in clinical research.The Report of an American Academy of Sleep Medicine Task Force[J].Sleep,1999,22(5):667

[13]EEG arousals:scoring rules and examples:a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association[J].Sleep,1992,15(2):173

[14]Recording and scoring leg movements.The Atlas Task Force[J].Sleep,1993,16(8):748

[15]高维杰,王彦,孙玫,等.持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征的依从性调查[J].中华结核和呼吸杂志,2011,34(1):68

[16]Weaver T E. Adherence to positive airway pressure therapy[J]. Curr Opin Pulm Med, 2006, 12(6): 409

[17]Olsen S, Smith S, Oei T P. Adherence to continuous positive airway pressure therapy in obstructive sleep apnoea sufferers: a theoretical approach to treatment adherence and intervention[J]. Clin Psychol Rev, 2008, 28(8): 1355

[18]Holley A B, Lettieri C J, Shah A A. Efficacy of an adjustable oral appliance and comparison with continuous positive airway pressure for the treatment of obstructive sleep apnea syndrome[J]. Chest, 2011, 140(6): 1511

[19]Randerath W J, Heise M, Hinz R, et al. An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome[J]. Chest, 2002, 122(2): 569

[20]Lam B, Sam K, Mok W Y, et al. Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea[J]. Thorax, 2007, 62(4): 354

[21]Pecotic R, Dodig I P, Valic M, et al. The evaluation of the Croatian version of the Epworth sleepiness scale and STOP questionnaire as screening tools for obstructive sleep apnea syndrome[J]. Sleep Breath, 2012, 16(3): 793

[22]Guimar?es C, Martins M V, Vaz Rodrigues L, et al. Epworth sleepiness scale in obstructive sleep apnea syndrome--an underestimated subjective scale[J]. Rev Port Pneumol, 2012, 18(6): 267

[23]Cai Si JIE, Chen Rui, Zhang Yan LIN, et al. Correlation of epworth sleepiness scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome[J]. Chin Med J (Engl), 2013, 126(17): 3245

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备注/Memo

备注/Memo:
作者简介 任庆伟 (1977-),男,主治医师,学士,研究方向:呼吸内科;E-mail:Rqw19810929@163.com
更新日期/Last Update: 2015-09-22