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目的 通过白天小睡与夜间睡眠Auto CPAP治疗时的压力滴定在中重度OSAHS患者中应用的对比研究 ,找出其差异性或规律性 ,同时为中重度OSAHS患者白天Auto CPAP治疗及压力滴定的可行性提供一客观依据。方法 选择 2 0 0 2 - 0 2～ 2 0 0 2 - 0 8北京协和医院呼吸内科门诊中睡眠时打鼾及白天嗜睡、睡眠时憋醒等不适主诉的患者行睡眠监测检查及Epworth嗜睡程度评价并筛选出AHI>2 0的OSAHS患者为研究对象。每位入选患者均于压力治疗滴定检查当日分别行午间及夜晚 2次Auto CPAP治疗滴定检查 ,白天小睡治疗滴定时间为1h至 2h 30min。测定项目包括 :睡眠呼吸紊乱指数 (AHI)、呼吸暂停指数 (AI)、低通气指数 (HI)、最长呼吸暂停和低通气持续时间 (LAHT)、最低甲床血氧饱和度 (LSaO2 )、治疗所需最高压力 (HP)、平均压力 (MP)、90 %压力(90 %P)和 95 %压力 (95 %P)。结果 Auto CPAP诊断治疗系统对于中重度睡眠呼吸暂停低通气患者的午间小睡与夜间治疗的效果显著且效果一致。中重度睡眠呼吸暂停低通气患者白天小睡时所需的治疗压力与夜间治疗时所需要的治疗压力差异无显著性 (P >0 0 5 )。结论 白天小睡Auto CPAP治疗及压力滴定能代替夜晚治疗时的压力滴定检查。
OBJECTIVE: To compare the differences between nocturnal sleep CPAP and auto-CPAP in patients with moderate-severe OSAHS and to find out the difference or regularity between them and the feasibility of daytime Auto CPAP treatment and pressure titration in patients with moderate-severe OSAHS Provide an objective basis. Methods: The patients who complained of snoring during sleep and daytime drowsiness during sleep, and those who complained of arousals during sleep, such as 200002002-2002-2008 at Peking Union Medical College Hospital, were evaluated for sleep monitoring and Epworth sleepiness The OSAHS patients with AHI> 20 were selected as the study subjects. Each enrolled patient underwent titration of Auto CPAP titration at midday and night, respectively, on the day of pressure therapy titration and daytime titration of 1h to 2h 30min. Measurements included AHI, AI, HI, LAT and LAaO2, LSaO2, Treatment required maximum pressure (HP), mean pressure (MP), 90% pressure (90% P) and 95% pressure (95% P). Results Auto CPAP diagnosis and treatment system for moderate to severe sleep apnea hypopnea patients with noon nap and night effect of a significant and effective. There was no significant difference in the treatment pressure needed for normobaric sleep apnea-hypopnea between daytime nausea and nighttime treatment (P> 0.05). Conclusion Nocturnal Auto CPAP treatment and pressure titration can replace the pressure titration during nighttime treatment.