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基于Meta分析的CPAP聯(lián)合常規(guī)降壓藥物對(duì)OSAHS合并高血壓患者的綜合療效分析 Comprehensive curative effect of CPAP combined with conventionalantihypertensive drugs on OSAHS patients with hypertensionbased on Meta-analysis |
| 作者： 雷強(qiáng) 呂云輝 李凱 孫睿 黃代金 相艷 馬磊 苗志斌 |
| 單位：昆明理工大學(xué)信息工程與自動(dòng)化學(xué)院 云南省第一人民醫(yī)院呼吸科 |
| 關(guān)鍵詞： Meta分析;持續(xù)氣道正壓通氣；阻塞性睡眠呼吸暫停低通氣綜合征；高血壓；治療效果 |
| 分類號(hào)： |
| 出版年·卷·期（頁碼）：2017·36·2（192-201） |
| 摘要： |
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目的 利用Meta分析評(píng)價(jià)持續(xù)氣道正壓通氣(continuous positive airway pressure，CPAP）聯(lián)合常規(guī)降壓藥物對(duì)阻塞性睡眠呼吸暫停低通氣綜合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并高血壓患者的綜合療效，為臨床治療提供參考。方法 計(jì)算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（Chinese BioMedical Literature Database，CBM）、Cochrane Library、PubMed、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（China National Knowledge Infrastructure，CNKI）、萬方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)，維普中文期刊服務(wù)平臺(tái)等電子數(shù)據(jù)庫并手工檢索相關(guān)期刊，查找CPAP治療對(duì)OSAHS合并高血壓患者綜合療效影響的臨床隨機(jī)對(duì)照試驗(yàn)（randomized controlled trial，RCT），對(duì)符合條件的RCT，逐一評(píng)價(jià)納入研究的質(zhì)量，提取入選文獻(xiàn)資料，采用RevMan5.3軟件進(jìn)行Meta分析，以Meta分析中的合并效應(yīng)統(tǒng)計(jì)參數(shù)探討CPAP聯(lián)合常規(guī)降壓藥物的治療效果。結(jié)果 共納入13篇文獻(xiàn)。Meta分析數(shù)據(jù)顯示：各項(xiàng)指標(biāo)差異均具有統(tǒng)計(jì)學(xué)意義［AHI：WMD=-25.19，95%CI（-34.05，-16.33），P<0.00001；LSaO2：WMD=17.57，95%CI（11.16，23.98），P<0.00001。白天平均收縮壓：WMD=-8.26，95%CI（-11.18，-5.34），P<0.00001；白天平均舒張壓：WMD=-6.42，95%CI（-8.25，-4.60），P<0.00001；夜間平均收縮壓：WMD=-12.92，95%CI（-19.65，-6.19），P<0.0002；夜間平均舒張壓：WMD=-6.31，95%CI（-8.53，-4.09），P<0.00001；24h平均收縮壓：WMD=-10.28，95%CI（-14.08，-6.48），P<0.00001；24h平均舒張壓：WMD=-6.99，95%CI（-8.88，-5.09），P<0.00001］。分析數(shù)據(jù)提示CPAP聯(lián)合常規(guī)降壓藥物治療后OSAHS合并高血壓患者各項(xiàng)指標(biāo)改善程度較對(duì)照組（常規(guī)藥物治療）均有明顯提升。漏斗圖基本對(duì)稱，存在發(fā)表偏倚可能性小。結(jié)論 CPAP聯(lián)合常規(guī)降壓藥物治療對(duì)我國OSAHS合并高血壓患者有確切的療效。 |
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Objective To evaluate the comprehensive curative effect of continuous positive airway pressure (CPAP) combinated with conventional antihypertensive drugs on the obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with hypertension by using meta-analysis method in order to provide a reference for the clinical treatment. Methods The related randomized controlled trial (RCT) literatures of comprehensive curative effects of CPAP on the OSAHS patients with hypertension were searched by computer from Chinese BioMedical Literature Database (CBM)，Cochrane Library，PubMed，China National Knowledge Infrastructure，Wanfang Data Knowledge Service Platform，and the relevant journals retrieved manually.Each eligible RCT was evaluated the quality and the literature was extracted.RevMan5.3 software was applied to carry out meta-analysis，and with the pooled meta-analysis we explored the curative effects of CPAP combined conventional antihypertensive drugs.Results A total of 13 articles were identified to meet the inclusion criteria.Meta-analysis showed that the differences of the indicators were statistically significant {Apnea hypopnea index ［WMD=-25.19，95%CI(-34.05,-16.33)，P<0.00001］，the lowest oxygen saturation at night［WMD=17.57，95%CI(11.16,23.98)，P<0.00001］，average systolic blood pressure and diastolic blood pressure during the day［WMD=-8.26，95%CI(-11.18,-5.34)，P<0.00001 and WMD=-6.42，95%CI(-8.25,-4.60)，P<0.00001，respectively］，night average systolic blood pressure and diastolic blood pressure［WMD=-12.92，95%CI(-19.65,-6.19)，P<0.0002 and WMD=-6.31，95%CI(-8.53,-4.09)，P<0.00001，respectively］，24 h average systolic blood pressure and diastolic blood pressure ［WMD=-10.28，95%CI (-14.08,-6.48)，P<0.00001 and WMD=-6.99，95% CI(-8.88,-5.09)，P<0.00001,respectively］}.The indicators of the CPAP group for OSAHS patients with hypertension improved significantly comparied with the control group (conventional drug treatment).The funnel schema was nearly symmetry with little bias.Conclusions The curative effect of CPAP combined with conventional antihypertensive drugs on OSAHS patients with hypertension is definite. |
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地址：北京安定門外安貞醫(yī)院內(nèi)北京生物醫(yī)學(xué)工程編輯部 電話：010-64456508 傳真：010-64456661 電子郵箱：[email protected] |