【双水平气道正压通气对重叠综合征患者心肺功能及睡眠质量的影响】双水平气道正压通气

　　[摘要] 目的 探讨双水平气道正压通气对重叠综合征患者心肺功能以及睡眠质量的影响。 方法 选择32例患者（观察组）使用双水平气道正压通气（BiPAP）治疗，并与31例（对照组）使用持续正压通气（CPAP）治疗的患者比较，观察治疗后患者心肺功能、血气分析的变化，并评价患者睡眠质量的改善情况，探讨两种治疗方法对患者的影响。 结果 治疗后观察组FEV1、FEV1/FVC以及FVC均显著较高于对照组（P ＜ 0.05）；观察组脑钠肽水平恢复正常，且显著低于对照组（P ＜ 0.05）；观察组pH、PaO2、PaCO2以及SpO2值均基本恢复正常，且治疗效果显著优于对照组（P ＜ 0.05）；观察组的最长呼吸暂停时间显著短于对照组（P ＜ 0.05），且睡眠紊乱指数和呼吸暂停指数均恢复正常，显著优于对照组（P ＜ 0.05）。 结论 BiPAP能有效改善患者的心肺功能和睡眠质量，是治疗重叠综合征的首选无创呼吸机治疗方法。
　　[关键词] 双水平气道正压；持续气道正压；重叠综合征；心肺功能；血气分析；睡眠质量
　　[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210（2012）07（b）-0035-03
　　Effect of BiPAP ventilation on cardiopulmonary function and sleep quality in patients with overlap syndrome
　　WANG Sihai
　　Department of Respiratory Medicine, General Hospital of Beijing Military, Beijing 100700, China
　　[Abstract] Objective To investigate the effect of BiPAP ventilation on cardiopulmonary function and sleep quality in patients with overlap syndrome. Methods 32 cases of patients (observation group) treated with BiPAP and 31 cases of patients (control group) treated with CPAP were compared. The cardiac and pulmonary function, changes of blood gas analysis were observed and the improvement condition of sleep quality was evaluated. The effect of two treatment methods on patients were discussed. Results After treatment FEV1, FEV1/FVC and FVC of the observation group were significantly higher than those of the control group (P < 0.05); the brain natriuretic peptide level of the observation group returned to normal, which was significantly lower than that of the control group (P < 0.05); pH, PaO2, PaCO2 and SpO2 of the observation group returned to normal and the curative effect was significantly better than those of the control group (P < 0.05); ongest apnea time of the observation group was significantly shorter than that of the control group (P < 0.05), and apnea hypopnea index, apnea index sleep returned to normal, which were significantly better than those of the control group (P < 0.05). Conclusion BiPAP can improve the heart, lung function and the sleep quality of patients, so it is the preferred noninvasive ventilator treatment method for overlap syndrome.
　　[Key words] BiPAP; CPAP; Overlap syndrome; Cardiopulmonary function; Blood gas analysis; Sleep quality
　　睡眠心脏健康研究表明，同时合并睡眠呼吸暂停综合征（SAHS）和慢性阻塞性肺部疾病（COPD）的患者发生睡眠中低氧的情况比只有其中一种疾病的患者严重[1-2]。目前在治疗重叠综合征（OS）上使用无创呼吸机治疗已经成为首选，但是具体选用何种模式治疗，仍未形成统一意见。国外虽有一些文献针对使用双水平气道正压通气（BiPAP）治疗与持续正压通气（CPAP）治疗的效果进行比较[3]，但其观察指标较为片面。本研究分析两种方法治疗后患者心肺功能、血气分析以及睡眠质量方面的变化情况，从而更加全面地为临床治疗提供指导，现报道如下：