缩唇-腹式呼吸训练联合持续气道正压通气对肥胖低通气综合征患者的疗效观察

关键词：肥胖低通气综合征  缩唇-腹式呼吸训练  持续气道正压通气  嗜睡  认知功能  生活质量

Keywords:obesity hypopnea syndrome  lip reduction-abdominal breathing training  continuous positive airway pressure  lethargy  cognitive function  quality of life

摘要：

      摘要 目的： 观察缩唇-腹式呼吸训练联合持续气道正压通气（CPAP）对肥胖低通气综合征（OHS）患者的疗效。 方法： 筛查出OHS患者60例，随机分为观察组30例、对照组30例，统计身高、体重、受教育程度，给予睡眠呼吸监测PSG、肺功能、血气、血清瘦素检查，评估Epworth嗜睡量表（ESS）、Calgary生活质量指数（SAQLI）、匹兹堡睡眠质量指数（PSQI）、蒙特利尔认知评估量表（MoCA）、简易精神状态检查量表（MMSE）评分。观察组给予缩唇-腹式呼吸训练联合CPAP治疗，对照组给予CPAP治疗，两组患者治疗3个月后、6个月后、12个月后复测以上资料，分析同组患者不同治疗时间段各指标差异，以及治疗12个月后两组患者以上指标的差异。 结果： 两组患者的性别、年龄、受教育年限、BMI、PSG监测指标（AHI、LSaO2、ODI）、血气指标（PaO2、PaCO2、pH值）、肺功能指标（VC%、FEV1/FVC）、瘦素水平、嗜睡评分（ESS、PSQI）、生活质量SAQLI评分、认知功能评分（MoCA、MMSE）差异无显著性意义（P>0.05）；两组患者BMI、AHI、血气指标（PaO2、PaCO2、pH值）、瘦素水平、嗜睡评分（ESS、PSQI）、生活质量SAQLI评分、认知功能评分（MoCA、MMSE）随着治疗时间延长均有改善（P<0.05）；但治疗12个月后观察组患者BMI、血气指标（PaO2、PaCO2、pH值）、瘦素水平、嗜睡评分（ESS、PSQI）、生活质量SAQLI评分、认知功能评分（MoCA、MMSE）较对照组有明显差异，差异有显著性意义（P<0.05），AHI差异无显著性意义（P>0.05）。 结论： 缩唇-腹式呼吸训练联合CPAP治疗较单纯CPAP治疗有明显疗效，可表现在肥胖状态、血气、瘦素水平、嗜睡症状、认知功能、生活质量等方面。

Abstract:

      Abstract Objective： To observe the effect of lip reduction-abdominal breathing training combined with continuous positive airway pressure (CPAP) in obese hypopnea syndrome (OHS) patients. Method： Sixty OHS patients were randomly divided into 30 cases in the observation group and 30 cases in the control group. The height， weight， education level， PSG， lung function， blood gas， and serum leptin were counted； the Epworth Sleepiness Scale (ESS)， Calgary Quality of Life Index (SAQLI)， Pittsburgh Sleep Quality Index (PSQI)， Montreal Cognitive Assessment Scale (MoCA)， Mini-mental State Examination (MMSE) were counted at the beginning of the intervention and 3,6,12months later. The observation group patients were given lip reduction-abdominal breathing training combined with CPAP treatment， and the control group patients were given CPAP treatment only. The two group were treated for 12 months. The above data were taken at the beginning, and 3, 6, 12 months latter. The differences at different time point were analyzed within group and between groups. Result： At the beginning ,The gender， age， years of education， BMI， PSG monitoring indicators (AHI， LSaO2， ODI)， blood gas (PaO2， PaCO2， pH value)， lung function (VC%， FEV1/FVC)，serum leptin level， sleepiness score (ESS， PSQI)， quality of life score (SAQLI)， cognitive function score (MoCA， MMSE) were not statistically different (P>0.05) between the two groups. After 12 months long treatment, all the above index were improved (P<0.05) for both groups；but the pH value, PaO2, PaCO2, serum leptin ESS , MoCA, MMSE , PSQLI ,SAQLI in observation group improved more than those in control group (P<0.05). Conclusion： The treatment of lip reduction-abdominal breathing training combined with CPAP treatment is more effective than CPAP treatment for patients with obesity hypopnea syndrome in obesity， blood gas， leptin level， drowsiness symptoms， cognitive function， quality of life， etc.