茶碱缓释胶囊对轻中度阻塞型睡眠呼吸暂停低通气综合征的影响

摘要

目的：观察轻中度阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者口服氨茶碱前后睡眠参数变化情况。方法随机选择60例经多导睡眠图（PSG）监测确诊的轻中度 OSAHS 患者，入选对象随机分成A、B 两组，A 组30例，给予口服茶碱缓释胶囊0.2/晚，B 组30例，给予安慰剂口服。比较未给药、口服茶碱后、口服安慰剂后睡眠监测指标变化情况，包括：睡眠呼吸暂停低通气指数（ apnea hypopnea index，AHI）、最低夜间血氧饱和度（LSaO2）、平均夜间血氧饱和度（MSaO2）、SaO2<90%时间、睡眠呼吸障碍最长时间，同时监测茶碱血药浓度，观察药物不良反应发生情况。结果（1）口服茶碱后 LSaO2：90.4%±2.1%，MSaO2：92.2%±1.5%，SaO2<90%时间（34.3±10.2）秒，睡眠呼吸障碍最长时间（25.0±2.3）秒，较未给药 LSaO2：86.2%±2.6%，MSaO2：89.1%±1.8%，SaO2<90%时间（45.1±18.6）秒，睡眠呼吸障碍最长时间（32.0±5.0）秒及给予安慰剂后 LSaO2：85.3%±3.8%，MSaO2：90.8%±2.6%，SaO2<90%时间（39.2±19.8）秒，睡眠呼吸障碍最长时间（31.0±3.4）秒，均有显著差异（P <0.017）。但 AHI 改变无统计学差异。口服安慰剂与未给药时比较，睡眠监测指标差异无统计学意义。（2）口服茶碱缓释胶囊，观察药物不良反应发生1例，表现为恶心，监测茶碱血药浓度在安全范围，停药后症状缓解。结论轻中度 OSAHS 睡前口服茶碱缓释胶囊安全有效，可缩短睡眠呼吸障碍最长时间，改善夜间 LSaO2、MSaO2、SaO2<90%时间。%Objective To observe the change of sleep parameters with oral aminophylline patients with mild or moderate obstructive sleep apnea hypopnea syndrome(OSAHS). Methods 60 patients with mild to moderate OSAHS diagnosed by PSG monitoring were randomly divided into two groups. The group A was given oral theophylline sustained release capsules 0. 2 / night,and the group B was given oral placebo. The sleep monitoring indexes were compared in oral theophylline,oral placebo and without medicine,such as AHI,LSaO2 ,MSaO2 ,the time of SaO2 less than 90% ,the longest time of sleep disordered breathing events in patients with OSAHS. At the same time,the-ophylline blood drug concentration was monitored,and the incidence of adverse drug reactions was observed. Results After oral theophylline,the value of LSaO2 was 90. 4% ± 2. 1% ,MSaO2 was 92. 2% ± 1. 5% ,the time of SaO2 less than 90% was(34. 3 ± 10. 2)s,and the longest time of sleep disordered breathing events was(25. 0 ± 2. 3)s. Before treatment,the value of LSaO2 was 86. 2% ± 2. 6% ,MSaO2 was 89. 1% ± 1. 8% ,the time of SaO2 less than 90% was(45. 1 ± 18. 6)s,and the longest time of sleep disordered breathing events was(32. 0 ± 5. 0)s. After oral placebo,LSaO2 was 85. 3% ± 3. 8% ,MSaO2 was 90. 8% ± 2. 6% ,the time of SaO2 less than 90% was(39. 2 ± 19. 8)s,and the longest time of sleep disordered breathing events was(31. 0 ± 3. 4)s. There was no significant difference in AHI between the two groups. There was one case of adverse drug reaction occurred after oral theophyl-line,characterized by nausea. The monitoring of theophylline serum concentration was in a safe range,after with-drawal symptom relief. Conclusion Theophylline sustained release capsules can significantly improve LSaO2 , MSaO2 ,the time of SaO2 less than 90% and the longest time of sleep disordered breathing events,which is safe and effective for patients with mild to moderate OSAHS.