经鼻持续气道正压通气对脑梗死合并阻塞性睡眠呼吸暂停低通气综合征患者的疗效评价

目的:评价脑梗死合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者应用经鼻持续气道正压通气(nCPAP)治疗后对认知、心理和日常生活能力的疗效。方法:共96例脑梗死合并OSAHS患者入选本研究,其中42例患者为治疗组,采用nCPAP治疗12周,另54例患者为观察组。2组患者在治疗前后均进行多导睡眠图(PSG)检测、D-二聚体测定及认知、心理、神经功能、日常生活能力评分,并对相关结果进行对比分析。结果:经nCPAP治疗12周后,治疗组在PSG各参数包括呼吸暂停低通气指数(AHI)、最低氧饱和度、氧饱和度低于90%的时间百分比、觉醒次数、非快速动眼期Ⅰ+Ⅱ期比例、Ⅲ+Ⅳ期比例、快速动眼期比例]的改善较观察组更明显(P<0.05)。简易精神状态检查(MMSE)评分总分较观察组明显改善(P<0.001),其中复述、计算、记忆力、语言各分项目评分有明显改善(P<0.01)。欧洲脑卒中量表评分(P

Therapeutic efficacy of nasal continuous positive airway pressure ventilation on cerebral infarction patients complicated with obstructive sleep apnea hypopnea syndrome

Objective To evaluate the therapeutic efficacy of nasal continuous positive airway pressure ventilation （nCRAP） on cerebral infarction patients complicated with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Ninety-six cerebral infarction patients complicated with OSAHS were divided into two groups. Fourty-two patients in treatment group were given nCPAP for 12 weeks, while the other 54 patients were served as controls. Polysomnography （PSG）, minimental status examination （MMSE）, European stroke scale, Barthel index （BI）, Hamilton anxiety scale （HAMA）, Hamilton rating scale for depression （HRSD） and D-dimer evaluated before and after treatment were compared. Results After 12weeks of nCPAP, PSG in treatment group improved significantly （P 〈0.05） when compared with that of control group, such as apnea hypopnea index （AHI） , lowest oxygen saturation , time percentage of oxygen saturation less than 90%, awakening numbers, Ⅰ ＋ Ⅱ proportion of sleep, Ⅲ＋Ⅳproportion of sleep, rapid eye movement （REM） proportion of sleep. MMSE in treatment group also improved significantly （P 〈0.001） when compared with that in control group, such as retell, calculation, memory and language. Compared with control group, European stroke scale （P 〈0.001）, BI（P =0.002）, HAMA（P 〈0.001）, HRSD （P 〈0.001） and D-dimer（P =0.035） improved significantly. Conclusions Twelve-week nCPAP could improve significantly the sleep, cognition, neurological function, psychology and D-dimer in cerebral infarction patients complicated with OSAHS.