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[日本的睡眠呼吸暂停综合征:病理生理学分析及经鼻持续气道正压通气的有效性]

[Sleep apnea syndrome in Japan: analysis of pathophysiology and nasal continuous positive airway pressure effectiveness].

作者信息

Takasaki Y, Ohta Y, Nishimura M, Kawakami Y, Kimura H, Kuriyama T, Akashiba T, Horie T, Ohi M, Kuno K

机构信息

Center for Sleep Disordered Breathing, Tokai University Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 1998 Jan;36(1):53-60.

PMID:9611977
Abstract

Forty eight Japanese sleep apnea syndrome (SAS) patients, whose apnea-hypopnea index (AHI) was more than 30 times/hr. from 5 university hospitals (46 males, 2 females) were enrolled in this study to analyze the characteristics of the disorder and the effectiveness of nasal continuous positive airway pressure (nCPAP) effectiveness. Although the severity of excessive daytime sleepiness (EDS), depressive state, and ventricular premature beats caused by SAS seemed milder in Japanese than reported Caucasian patients, the prevalences of hypertension and glucose intolerance were quite high: 50 and 30% respectively. Treatment with nCPAP for 3 months was completed in 41 of 48 enrollees, a compliance rate of 85.4%, which was substantially higher than studies from Western countries. nCPAP treatment normalized about 50% of hypertensive patients and more than half of glucose intolerant patients. Moreover, EDS, driving ability, the severity of arrhythmia, and so forth were all improved with nCPAP. We, therefore, conclude that 1) SAS could differ between Japanese Caucasians in terms of clinical features resulting from SAS and 2) treatment with nCPAP is effective and should be considered as first-line treatment for patients with moderate to severe SAS, as reported in Western countries.

摘要

来自5所大学医院的48例日本睡眠呼吸暂停综合征(SAS)患者(46例男性,2例女性)被纳入本研究,这些患者的呼吸暂停低通气指数(AHI)超过30次/小时,旨在分析该疾病的特征以及鼻持续气道正压通气(nCPAP)的有效性。尽管在日本,由SAS引起的白天过度嗜睡(EDS)、抑郁状态和室性早搏的严重程度似乎比报道的白种人患者轻,但高血压和糖耐量异常的患病率相当高,分别为50%和30%。48名受试者中有41名完成了3个月的nCPAP治疗,依从率为85.4%,这大大高于西方国家的研究。nCPAP治疗使约50%的高血压患者和超过一半的糖耐量异常患者的病情恢复正常。此外,nCPAP治疗还改善了EDS、驾驶能力、心律失常的严重程度等。因此,我们得出结论:1)SAS在日本人和白种人之间的临床特征可能存在差异;2)正如西方国家报道的那样,nCPAP治疗是有效的,应被视为中重度SAS患者的一线治疗方法。

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