摘要
目的通过对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊治,检测不同时段肌酸磷酸激酶(CPK)在患者血清中的水平,探讨OSAHS患者的肌酸磷酸激酶(CPK)水平与呼吸暂停低通气指数(AHI)、最低血氧饱和度(Sa O2%)及血压之间的相互关系及意义。方法对30例重度OSHAS患者(阻塞平面为口咽平面狭窄)进行持续正压通气(CPAP)治疗1周改善患者缺氧情况,然后行改良悬雍垂腭咽成形术(Uvula palate pharyngoplasty,UPPP),应用酶比色法定量测定患者持续正压通气(CPAP)治疗前及治疗1周后血清中的肌酸磷酸激酶(CPK)水平,以及改良悬雍垂腭咽成形术(UPPP)术后1周、3月及6月血清中的肌酸磷酸激酶(CPK)水平,同时监测(AHI)、最低Sa O2%、及血压变化情况,检测10例体检健康志愿者血清中的肌酸磷酸激酶(CPK)水平作对照。结果重度OSAHS组治疗前肌酸磷酸激酶(CPK)与健康对照组比较,肌酸磷酸激酶(CPK)水平明显高于对照组(P<0.01);持续正压通气治疗可有效降低重度OSAHS患者血清中的CPK,CPAP治疗前后血清中的CPK比较,差异具有统计学意义(P<0.05);改良UPPP术后1周、3月、6月血清肌酸磷酸激酶(CPK)水平较术前逐渐降低(P<0.05);重度OSAHS患者血清中的肌酸磷酸激酶(CPK)与舒张压(DBP)、AHI均呈正相关,与Sa O2%呈负相关。术后6月患者睡眠呼吸暂停及低通气得到明显改善。结论肌酸磷酸激酶(CPK)、低通气指数(AHI)、最低Sa O2%及舒张压(DBP)等可作为OSAHS病情严重程度及预后综合判断的参考指标。
Objective To examine creatine phosphokinase（CPK） levels in the diagnosis and treatment of obstructive sleep apnea hypopnea syndrom（OSAHS） at the different stages,and correlate serum levels of CPK with AHI,Sa O2%,and blood pressure.Methods 30 patients with severe OSHAS（blocking plane as a narrow oropharynx plane） were subjected for continuous positive airway pressure（CPAP） therapy for 1 week to improve the anoxic condition,and then received modified ZPP line pharyngoplasty（Uvula palate pharyngoplasty,UPPP）.The application of enzyme colorimetric method for the quantitative determination of for CPK levels in patients with continuous positive airway pressure（CPAP） before and after 1 week of treatment,and in patients received the Uvula palate pharyngoplasty（UPPP） in postoperative 1 week,3 month and 6 month.At the same time,the AHI index,lowest Sa O2% and blood pressure changes were also determined.Serum CPK levels in 10 cases of medical healthy volunteers were compared.Results In severe OSAHS groups before treatment CPK levels were significantly higher than control group（P 〈0.01）;CPAP therapy can effectively reduce the severity of patients with OSAHS and resuced serum CPK levels（P 〈0.05）;Modified UPPP in postoperative 1 week,3 and 6months,CPK levels were gradually reduced（P〈 0.05）;In severe OSAHS patients serum creatine phosphokinase（CPK） was positively correlated with DBP,AHI,and negatively correlated with Sa O2%.Postoperative patients with sleep apnea 6 months after treatment showed improvement.Conclusion Creatine phosphokinase（CPK）,apnea-hypopnea index（AHI） and lowest blood oxygen saturation（Sa O2%） and diastolic blood pressure（DBP） can be used as OSAHS disease severity and prognosis of comprehensive judgment reference index.
出处
《遵义医学院学报》
2015年第3期285-288,共4页
Journal of Zunyi Medical University
基金
遵义市汇川区科学技术基金资助项目(NO:209.01.122.05)
关键词
阻塞性睡眠呼吸暂停低通气综合征
悬雍垂腭咽成形术
肌酸磷酸激酶
持续正压通气
obstruc-tive sleep apnea-hypopnea syndrome（OSAHS）
uvula palate pharyngoplasty（UPPP）
creatine phosphatic kinase（CPK）
continue positive airway pressure（CPAP）
