Yang L N, Sun J
Department of Otorhinolaryngology, Affiliated hospital of Inner Mongolia medical university, Hohhot 010059, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb 7;55(2):159-162. doi: 10.3760/cma.j.issn.1673-0860.2020.02.014.
To observe the efficacy of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) and its affection on patients' blood gas analysis, C reactive protein(CRP) levels. This prospective study was performed from October 2016 to July 2017. Fifty hospitalized adult patients with medium or severe OSAHS, who were diagnosed by polysomnography (PSG) in Department of Otorhinolaryngology, Affiliated Hospital of Inner Mongolia Medical University, were collected as a case group. Those patients met the standards of medium or severe OSAHS, among whom 40 were male, 10 were female, the age was between 30 and 65, with a mean age of (47.24±10.28) years, and BMI was (27.94±3.43) kg/m(2). Meanwhile, 50 healthy individuals were chose in the same term as a control group, among whom 37 were male, 13 were female, the age was between 29 and 69, with a mean age of (51.28±10.58) years, body mass index(BMI) was (26.98±2.70) kg/m(2), and apnea-hypopnea index (AHI) was<5/h. The differences of blood gas analysis pH, arterial oxygen saturation (SaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial partial pressure of oxygen (PaO(2)), CRP before and after the treatment of CPAP in case group and in the control group were compared. The choosing data were disposed and analyzed with statistics software of SPSS 20.0. Among which test was adopted for measurement data, χ(2) test was adopted for enumeration data, and nonparametric rank sum test was adopted for other measurement data. Before the CPAP treatment, pH, PaO(2) and SaO(2) levels in case group were lower than that in control group, respectively [7.34±0.03 . 7.37±0.04, (75.93±9.08) mmHg . (80.07±10.94) mmHg (1 mmHg=0.133 kPa), (89.71±6.09) mmHg .(93.29±5.36) mmHg, all <0.05]. Both PaCO(2) level and CRP were higher than that in control group [(43.02±8.43) mmHg .(39.26±8.20) mmHg, 1.28[0.27,5.83] mg/L(Median[(25),(75)]) . 0.51[0.21,2.13] mg/L, both <0.05]. After the CPAP treatment, pH(7.36±0.04), PaO(2) [(80.28±9.96) mmHg] and SaO(2) [(92.94±4.01) mmHg] level in case group were increased than pretreatment, respectively. Moreover, PaCO(2) level [(39.46±8.36) mmHg] and CRP(0.44[0.21,3.40] mg/L) are decreased than pretreatment (<0.05), respectively. The CRP and blood gas analyses are significant index to evaluate the state of an illness and to estimate the prognosis of disease of OSAHS, which is deserved to generalize.
观察持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效及其对患者血气分析、C反应蛋白（CRP）水平的影响。本前瞻性研究于2016年10月至2017年7月进行。选取内蒙古医科大学附属医院耳鼻咽喉科经多导睡眠监测（PSG）确诊的50例中重度OSAHS成年住院患者作为病例组。这些患者符合中重度OSAHS标准，其中男性40例，女性10例，年龄30至65岁，平均年龄（47.24±10.28）岁，体重指数（BMI）为（27.94±3.43）kg/m²。同时，同期选取50例健康个体作为对照组，其中男性37例，女性13例，年龄29至69岁，平均年龄（51.28±10.58）岁，体重指数（BMI）为（26.98±2.70）kg/m²，呼吸暂停低通气指数（AHI）<5次/小时。比较病例组和对照组CPAP治疗前后血气分析pH值、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）、动脉血氧分压（PaO₂）、CRP的差异。选取的数据用SPSS 20.0统计软件进行处理和分析。其中计量资料采用t检验，计数资料采用χ²检验，其他计量资料采用非参数秩和检验。CPAP治疗前，病例组pH值、PaO₂和SaO₂水平分别低于对照组[7.34±0.03、7.37±0.04，（75.93±9.08）mmHg、（80.07±10.94）mmHg（1 mmHg = 0.133 kPa），（89.71±6.09）mmHg、（93.29±5.36）mmHg，均P<0.05]。PaCO₂水平和CRP均高于对照组[（43.02±8.43）mmHg、（39.26±8.20）mmHg，1.28[0.27，5.83]mg/L（中位数[（25），（75）]）、0.51[0.2I，2.13]mg/L，均P<0.05]。CPAP治疗后，病例组pH值（7.36±0.04）、PaO₂[（80.28±9.96）mmHg]和SaO₂[（92.94±4.01）mmHg]水平均较治疗前升高。此外，PaCO₂水平[（39.46±8.36）mmHg]和CRP（0.44[0.21，3.40]mg/L）均较治疗前降低（均P<0.05）。CRP和血气分析是评估OSAHS病情状态及估计疾病预后的重要指标，值得推广。
