Mo Li, He Quan-ying
Department of Respiration, Renmin Hospital, Peking University, Beijing 100044, China.
Zhonghua Yi Xue Za Zhi. 2007 May 8;87(17):1177-80.
To explore whether long-term continuous positive airway pressure (CPAP) ventilation is effective to decrease the blood pressure in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) accompanied with hypertension.
Literatures of relevant randomized, controlled, prospective, clinical trials 2000 - 2006 in English and Chinese were retrieved from Medline and CNKI based on the criteria: the subjects being patients with OSAHS, the study lasting at least 4 weeks, and the effect on 24 hours ambulatory blood pressure in CPAP group being compared with that in no-CPAP group. The data thus collected underwent meta-analysis.
471 cases in 7 studies were included. Three of the 7 studies indicated that CPAP ventilation could decrease the diastolic blood pressure in the patients with OSAHS and four studies showed no significant difference in the effect of CPAP on blood pressure between the two groups. From meta-analysis, the weighted mean difference (WMD) in fixed effect model of 24 h diastolic blood pressure (DBP) was -1.78 [95% CI: -3.34, -0.22]; the WMD (fixed) of 24 h systolic blood pressure (SBP) was -0.95 [95% CI: -2.85, 0.94], and the WMD (random) of 24 h mean blood pressure (MBP) was -1.25 [95% CI: -4.00, 1.49].
The long-term CPAP ventilation can decrease the 24 h DBP.
探讨长期持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者血压的影响。
根据纳入标准,检索2000年至2006年期间Medline和中国知网(CNKI)收录的中英文相关随机对照前瞻性临床试验文献:研究对象为OSAHS患者,研究持续时间至少4周,比较CPAP组与非CPAP组对24小时动态血压的影响。对收集的数据进行荟萃分析。
纳入7项研究中的471例患者。7项研究中有3项表明CPAP通气可降低OSAHS患者的舒张压,4项研究显示两组间CPAP对血压的影响无显著差异。荟萃分析结果显示,固定效应模型下24小时舒张压(DBP)的加权平均差(WMD)为-1.78 [95%可信区间(CI):-3.34,-0.22];24小时收缩压(SBP)的WMD(固定)为-0.95 [95% CI:-2.85,0.94],24小时平均血压(MBP)的WMD(随机)为-1.25 [95% CI:-4.00,1.49]。
长期CPAP通气可降低24小时舒张压。