渐进式步行方案对阻塞性睡眠呼吸暂停综合征严重程度的影响。一项随机临床试验。
Effect of a Graduated Walking Program on the Severity of Obstructive Sleep Apnea Syndrome. A Randomized Clinical Trial.
机构信息
Department of Physiotherapy, San Juan de Dios Hospital Cordoba, 14012 Cordoba, Spain.
Department of Nursing, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain.
出版信息
Int J Environ Res Public Health. 2020 Aug 31;17(17):6334. doi: 10.3390/ijerph17176334.
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) is a common disease. The objective of this research was to determine the effectiveness of a graduated walking program in reducing the apnea-hypopnea index number in patients with obstructive sleep apnea syndrome (OSAS).
METHODS
A randomized controlled clinical trial with a two-arm parallel in three tertiary hospitals was carried out with seventy sedentary patients with moderate to severe OSAS. Twenty-nine subjects in each arm were analyzed by protocol. The control group received usual care, while usual care and an exercise program based on progressive walks without direct supervision for 6 months were offered to the intervention group.
RESULTS
The apnea-hypopnea index decreased by six points in the intervention group, and improvements in oxygen desaturation index, total cholesterol, and Low-Density Lipoprotein of Cholesterol (LDL-c) were observed. A higher decrease in sleep apnea-hypopnea index (45 ± 20.6 vs. 34 ± 26.3/h; = 0.002) was found in patients with severe vs. moderate OSAS, as well as in oxygen desaturation index from baseline values (43.3 vs. 34.3/h; = 0.046). Besides, High-Density Lipoprotein of Cholesterol (HDL-c) values showed a higher increase in the intervention group (45.3 vs. 49.5 mg/dL; = 0.009) and also, a higher decrease in LDL-c was found in this group (141.2 vs. 127.5 mg/dL; = 0.038).
CONCLUSION
A home physical exercise program is a useful and viable therapeutic measure for the management of OSAS.
背景
阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见疾病。本研究旨在确定分级步行方案在降低阻塞性睡眠呼吸暂停综合征（OSAS）患者的呼吸暂停低通气指数方面的有效性。
方法
在三家三级医院进行了一项随机对照临床试验，共有 70 名久坐不动的中重度 OSAS 患者参与。按照方案对每组 29 名患者进行分析。对照组接受常规护理，而干预组则接受常规护理和基于渐进性步行的运动方案，但没有直接监督，为期 6 个月。
结果
干预组的呼吸暂停低通气指数降低了 6 个点，并且观察到氧减饱和度指数、总胆固醇和低密度脂蛋白胆固醇（LDL-c）的改善。在严重 OSAS 患者中发现睡眠呼吸暂停低通气指数的降低幅度更高（45 ± 20.6 与 34 ± 26.3/h； = 0.002），与中度 OSAS 患者相比，基线值的氧减饱和度指数也有更高的降低（43.3 与 34.3/h； = 0.046）。此外，干预组的高密度脂蛋白胆固醇（HDL-c）值显示出更高的升高（45.3 与 49.5 mg/dL； = 0.009），并且 LDL-c 的降低幅度也更高（141.2 与 127.5 mg/dL； = 0.038）。
结论
家庭体育锻炼方案是 OSAS 管理的一种有用且可行的治疗措施。
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