Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive steep apnea syndrome
Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive steep apnea syndrome
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DOI：
10.1016/j.rmed.2004.10.011
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发表时间：
2005-05-01
影响因子：
4.3
通讯作者：
Turktas, H
中科院分区：
文献类型：
--
作者：
Ciftci, TU;Ciftci, B;Turktas, H
夜间哮喘的发病机制与昼夜节律密切相关，昼夜节律影响炎性细胞和介质、激素水平和胆碱能张力。哮喘患者夜间气道狭窄有时与严重疾病有关，如阻塞性睡眠呼吸暂停综合征（OSAS）。本研究的目的是评估夜间哮喘与OSAS的关系，并探讨持续气道正压通气（CPAP）治疗对改善哮喘合并OSAS患者夜间症状的影响。研究了43例哮喘患者，尽管根据全球哮喘倡议指南进行了最佳药物治疗，但仍有夜间症状，并伴有打鼾。对所有患者进行肺功能检查（PFT）、哮喘夜间症状评分和多导睡眠图检查。我们对呼吸暂停低通气指数（AHI）≥ 15（中重度OSAS）的患者（n = 16）进行了为期2个月的CPAP治疗。2个月后，再次进行PFT、哮喘夜间症状评分。OSAS患者CPAP治疗前后PFT值无显著性差异。CPAP治疗后哮喘夜间症状评分明显改善（P < 0.05）。结论：在某些夜间哮喘患者中，OSAS可能是导致夜间症状的原因。在这种情况下，CPAP可改善夜间症状，而PFT异常无改善。(c)2004爱思唯尔有限公司保留所有权利。
The mechanisms of nocturnal asthma are intimately related to circadian rhythms, which influence inflammatory cells and mediators, hormone levels and cholinergic tone. Nocturnal airway narrowing in asthma is sometimes associated with steep disorders, such as obstructive sleep apnea syndrome (OSAS). The aims of this study were to evaluate the association of nocturnal asthma and OSAS, and investigate the influence of continuous positive airway pressure (CPAP) therapy to improve nighttime symptoms in asthmatic patients with OSAS. Forty-three asthmatic patients who had nocturnal symptoms in spite of the optimal medical treatment according to the Global Initiative for Asthma guidelines and associated with snoring were studied. Pulmonary function tests (PFTs), asthma nighttime symptom scores, and polysomnography were performed on all patients. We treated the patients with an apnea-hypopnea index (AHI) >= 15 (moderate-severe OSAS) (n = 16) with CPAP during 2 months. After 2 months, PFT, asthma nighttime symptom scores were reperformed. There was no significant difference in PFT values before and after CPAP treatment in OSAS patients. Asthma nighttime symptom scores were improved significantly (P < 0.05) after CPAP treatment. In conclusion, in some patients with nocturnal asthma, OSAS may be responsible disease for nocturnal symptoms. In this condition, CPAP improves nocturnal symptoms without amelioration in PFT abnormalities. (c) 2004 Elsevier Ltd. All rights reserved.