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持续气道正压通气治疗轻度睡眠呼吸暂停低通气综合征的疗效

Effectiveness of continuous positive airway pressure in mild sleep apnea-hypopnea syndrome.

作者信息

Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbé F, Mayos M, Gonzalez-Mangado N, Juncadella M, Navarro A, Barreira R, Capote F, Mayoralas L R, Peces-Barba G, Alonso J, Montserrat J M

机构信息

Serveis de Pneumologia of Ciutat Sanitària i Universitària de Bellvitge, Hospital Txagorritxu, Fundacion Jimenez Diaz, Hospital Clinic, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.

出版信息

Am J Respir Crit Care Med. 2001 Sep 15;164(6):939-43. doi: 10.1164/ajrccm.164.6.2008010.

Abstract

The aim of this trial was to evaluate the effectiveness of continuous positive airway pressure (CPAP) in patients with mild sleep apnea- hypopnea syndrome (SAHS). One hundred forty-two consecutive patients with mild SAHS (apnea-hypopnea index 10-30, without severe sleepiness) were randomly assigned to receive conservative treatment (CT)-sleep hygiene and weight loss-(65 patients) or CT plus CPAP (77 patients), and 125 patients (86% males, age: 54 +/- 9 yr, BMI: 29 +/- 4 kg/m(2), AHI: 20 +/- 6, ESS: 12 +/- 4) completed the follow-up. The following outcomes were assessed at inclusion and after 3 and 6 mo of treatment: sleepiness (Epworth scale, multiple sleep latency test [MSLT]), other symptoms related to SAHS, cognitive function, and perceived health status (Functional Outcomes of Sleep Questionnaire [FOSQ], Nottingham Health profile). The relief of SAHS-related clinical symptoms was significantly greater in the CPAP group than in the CT group; the Epworth scale and FOSQ also showed more improvement in the CPAP group but did not reach significance. There were no significant differences in the other tests performed probably because the baseline values were normal. CPAP compliance was 4.8 +/- 2.2 h and treatment continuation was accepted by 62% of the patients at the end of the study. These results suggest that CPAP can be considered in treating patients with mild SAHS on the basis of an improvement in symptoms.

摘要

本试验的目的是评估持续气道正压通气(CPAP)对轻度睡眠呼吸暂停低通气综合征(SAHS)患者的疗效。142例连续性轻度SAHS患者(呼吸暂停低通气指数为10 - 30,无严重嗜睡)被随机分配接受保守治疗(CT)——睡眠卫生和减重——(65例患者)或CT加CPAP(77例患者),125例患者(86%为男性,年龄:54±9岁,体重指数:29±4kg/m²,呼吸暂停低通气指数:20±6,Epworth嗜睡量表评分:12±4)完成了随访。在入组时以及治疗3个月和6个月后评估以下指标:嗜睡程度(Epworth量表、多次睡眠潜伏期试验[MSLT])、与SAHS相关的其他症状、认知功能以及感知健康状况(睡眠问卷功能结局[FOSQ]、诺丁汉健康量表)。CPAP组SAHS相关临床症状的缓解程度显著大于CT组;Epworth量表和FOSQ在CPAP组也显示出更多改善,但未达到显著差异。其他所进行的测试无显著差异,可能是因为基线值正常。CPAP的依从性为4.8±2.2小时,在研究结束时62%的患者接受继续治疗。这些结果表明,基于症状改善,CPAP可被考虑用于治疗轻度SAHS患者。

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