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目的探讨无创呼吸机治疗对儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)炎症反应的影响及疗效分析。方法选取2014年1月—2015年12月80例中度OSAHS患儿,随机分为常规治疗组及CPAP组,二组患儿均予以积极锻炼、改善睡姿、控制性饮食、预防肥胖症等常规治疗,CPAP组联合无创呼吸机辅助通气支持治疗,疗程3个月。观察二组患儿治疗前后血清缺氧诱导因子-1α(HIF-1α)、肿瘤坏死因子-α(TNF-α)水平及多导睡眠监测(PSG)疗效分析。结果二组患儿血清HIF-1α、TNF-α水平较治疗前均降低(P<0.05),但CPAP组较常规治疗组显著降低(P<0.05);二组患儿呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSpO2)、平均血氧饱和度(MSpO2)均较治疗前明显改善(P<0.05),但CPAP组改善程度显著高于常规治疗组(P<0.05)。结论无创呼吸机辅助通气治疗儿童OSAHS在显著改善睡眠的同时,可有效降低血清HIF-1α、TNF-α水平,减轻患儿机体炎症反应。
Objective To investigate the effects of noninvasive ventilator therapy on the inflammatory response in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and analyze its curative effect. Methods From January 2014 to December 2015, 80 patients with moderate OSAHS were randomly divided into routine treatment group and CPAP group. Both groups were given active exercise to improve sleeping posture, controlled diet and prevention of obesity Conventional treatment, CPAP group combined with noninvasive ventilator assisted ventilation support treatment, 3 months. The levels of serum hypoxia inducible factor-1α (HIF-1α), tumor necrosis factor-α (TNF-α) and polysomnography (PSG) in two groups of children before and after treatment were observed. Results Serum levels of HIF-1α and TNF-α in two groups were significantly lower than those before treatment (P <0.05), but CPAP group was significantly lower than the conventional treatment group (P <0.05). The apnea-hypopnea index AHI, LSpO2 and MSpO2 were significantly improved (P <0.05), but the improvement in CPAP group was significantly higher than that in routine treatment group (P <0.05). Conclusion Noninvasive ventilator-assisted ventilation in children with OSAHS significantly improve sleep, while reducing serum HIF-1α, TNF-α levels and reduce the body’s inflammatory response in children.