Objective To explore the effect of noninvasive positive pressure ventilation on the incidence of cardiovascular disease in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 66 OSAHS patients from June 2014 to September 2015 in our hospital were randomly divided into two groups, 33 cases in each group.The study group was treated with nasal continuous positive airway pressure (CPAP) mode, and the control group was treated with general oxygen therapy.Both groups were continuously for days.The following indexes were compared before and after treatment between the two groups, respiratory parameters and sleep apnea hypopnea index (AHI), the lowest oxygen saturation (SpO2), average SpO2, the longest apnea time, the average time of apnea and heart rate variability parameters (SDNN, rMMSD, HF, LF and LF/HF), serum inflammatory factors (IL-6, CRP, TNF-a) and oxidative stress index (8-isoprostanes, alcohol nitrotyrosine).Results (1) There was no significant difference in AHI, the lowest SpO2, average SpO2, or average apnea time between the two groups before treatment (P>0.05), and AHI, the longest apnea time and average apnea time were lower, and the lowest SpO2 and average SpO2 were higher in the study group than in the control group (P<0.05).(2) The incidence rate of sinus tachycardia, sinus arrest, ventricular tachycardia, arrhythmia and atrial tachycardia was lower in the study group than in the control group (P<0.05).(3) The levels of SDNN, rMMSD, HF, LF and LF/HF showed no statistically significant difference before treatment (P>0.05), and the levels of SDNN, rMMSD and HF were higher, and LF and LF/HF levels were lower in the study group than in the control group (P<0.05).(4) The levels of IL-6, CRP, TNF-a, 8-ISO epoprosteno, and nitrotyrosine showed no significant difference before treatment (P>0.05), and they were lower in the study group than in the control group (P<0.05).Conclusion Noninvasive positive pressure ventilation has significant effect in treatment of obstructive sleep apnea hypopnea syndrome, which can improve the sleep condition and heart rate variability, reduce the incidence of cardiovascular events, and reduce inflammation and oxidative stress reaction.%目的 探究无创正压通气对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者心血管疾病发生率的影响.方法 抽取2014年6月-2015年9月我院66例OSAHS患者,通过随机数表法分组,各33例.研究组选用经鼻持续正压通气(CPAP)模式,对照组选用普通氧疗,两组均持续治疗3d.对比治疗前后两组呼吸参数;睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(SpO2)、平均SpO2、最长呼吸暂停时间、平均呼吸暂停时间]、心率变异参数;夜间正常呼吸频率间期标准差(SDNN)、相邻呼吸频率间期均方根(rMMSD)、高频(HF)、低频(LF)及LF/HF]、血清炎性因子;白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及氧化应激指标(8-异前列醇素、硝基酪氨酸)水平变化情况,统计两组心血管疾病发生率.结果 (1)呼吸参数:治疗前两组AHI、最低SpO2、平均SpO2、最长呼吸暂停时间、平均呼吸暂停时间对比差异无统计学意义(P>0.05),治疗后研究组AHI、最长呼吸暂停时间、平均呼吸暂停时间低于对照组,最低SpO2、平均SpO2高于对照组,差异有统计学意义(P<0.05);(2)心血管疾病:研究组窦性心动过缓、窦性停搏、室性心动过速、复杂心律失常、房性心动过速发生率低于对照组,差异有统计学意义(P<0.05);(3)心率变异参数:治疗前两组SDNN、rMMSD、HF、LF及LF/HF水平对比差异无统计学意义(P>0.05),治疗后研究组SDNN、rMMSD、HF水平高于对照组,LF及LF/HF水平低于对照组,差异有统计学意义(P<0.05);(4)血清炎性因子及氧化应激:治疗前两组IL-6、CRP、TNF-α、8-异前列醇素、硝基酪氨酸水平对比差异无统计学意义(P>0.05),治疗后研究组各指标水平低于对照组,差异有统计学意义(P<0.05).结论 采用无创正压通气治疗阻塞性睡眠呼吸暂停低通气综合征效果显著,可改善患者睡眠状况及心率变异性,降低心血管事件发生率,减轻炎症反应与氧化应激反应.
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