The effect of continuous positive airway pressure ventilation on mean airway pressure and neurological function in stroke patients with obstructive sleep apnea syndrome

doi:10.11958/20250596

Abstract

Abstract:

Objective To investigate the effects of continuous positive airway pressure (CPAP) on mean airway pressure and neurological function in cerebral infarction patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Methods A total of 245 patients with cerebral infarction complicated with OSAS (who received treatment in our hospital from February 2020 to October 2023) were collected and studied by prospective study. Among them, 152 patients received basic intervention measures such as conventional drugs and rehabilitation therapy, and 93 patients received CPAP therapy on the basis of basic intervention measures. Matching according to 1∶1 propensity score matching method, 48 cases were divided into the control group and 48 cases were used as the observation group. The treatment period of the two groups was 14 days. Before treatment and after 14 days of treatment, the oxygen desaturation index (ODI), lowest oxygen saturation (LS_aO₂), respiratory mechanics indexes [airway resistance (Raw), mean airway pressure (MPaw) and peak inspiratory pressure (PIP)], neurological function scores [National Institutes of Health Stroke Scale (NIHSS) score, modified Rankina scale (mRS) score after 3 months] and Barthel index (BI) score were compared between the two groups, and the efficacy and the occurrence of adverse reactions were evaluated. Results After 14 days of treatment, the ODI, respiratory mechanics indexes Raw, MPaw, PIP, NIHSS score and mRS score were greatly reduced in the two groups, however, LS_aO₂ and BI score was increased (P<0.05). The ODI, Raw, MPaw, PIP, NIHSS score and mRS score were lower in the observation group than those of the control group, while LS_aO₂ and BI score were higher in the observation group than those of the control group (P<0.05). The total effective rate of the observation group was higher than that of the control group (87.5% vs. 68.8%, P=0.026). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.673). Conclusion CPAP is beneficial for reducing MPaw, improving oxygen saturation and neurological function, and increasing total effective rate in patients with cerebral infarction combined with OSAS. It can be widely applied in clinical practice.

Key words: continuous positive airway pressure, sleep apnea, obstructive, brain infarction, mean airway pressure, neurological function

CLC Number:

R563，R743.3

Figures/Tables 6

References 20

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组别	年龄/岁			男性		体质量指数/（kg/m²）		糖尿病		高血压		病程/d
对照组	64.75±7.19			27（56.3）		24.12±3.17		10（20.8）		13（27.1）		28.65±5.83
观察组	65.02±7.22			23（47.9）		23.95±3.58		7（14.6）		11（22.9）		29.25±6.29
t或χ²	0.184			0.668		0.232		0.643		0.222		0.488
组别		梗死部位					冠心病		吸烟史		饮酒史		高脂血症
组别		前循环	后循环		前后循环		冠心病		吸烟史		饮酒史		高脂血症
对照组		25（52.1）	15（31.3）		8（16.7）		16（33.3）		14（29.2）		19（39.6）		25（52.1）
观察组		24（50.0）	17（35.4）		7（15.6）		17（35.4）		12（25.0）		16（33.3）		23（47.9）
χ²		0.212					0.046		0.211		0.405		0.167

组别	年龄/岁			男性		体质量指数/（kg/m²）		糖尿病		高血压		病程/d
对照组	64.75±7.19			27（56.3）		24.12±3.17		10（20.8）		13（27.1）		28.65±5.83
观察组	65.02±7.22			23（47.9）		23.95±3.58		7（14.6）		11（22.9）		29.25±6.29
t或χ²	0.184			0.668		0.232		0.643		0.222		0.488
组别		梗死部位					冠心病		吸烟史		饮酒史		高脂血症
组别		前循环	后循环		前后循环		冠心病		吸烟史		饮酒史		高脂血症
对照组		25（52.1）	15（31.3）		8（16.7）		16（33.3）		14（29.2）		19（39.6）		25（52.1）
观察组		24（50.0）	17（35.4）		7（15.6）		17（35.4）		12（25.0）		16（33.3）		23（47.9）
χ²		0.212					0.046		0.211		0.405		0.167

组别	ODI			LS_aO₂
组别	治疗前	治疗14 d后	t	治疗前	治疗14 d后	t
对照组	31.02±7.76	22.42±4.48	6.594^＊＊	79.63±8.85	85.60±5.71	3.664^＊＊
观察组	31.25±7.81	14.88±4.96	12.915^＊＊	79.25±8.81	92.75±5.80	7.679^＊＊
t	0.145	7.814^＊＊		0.206	6.094^＊＊

组别	ODI			LS_aO₂
组别	治疗前	治疗14 d后	t	治疗前	治疗14 d后	t
对照组	31.02±7.76	22.42±4.48	6.594^＊＊	79.63±8.85	85.60±5.71	3.664^＊＊
观察组	31.25±7.81	14.88±4.96	12.915^＊＊	79.25±8.81	92.75±5.80	7.679^＊＊
t	0.145	7.814^＊＊		0.206	6.094^＊＊

组别	Raw			MPaw			PIP
组别	治疗前	治疗14 d后	t	治疗前	治疗14 d后	t	治疗前	治疗14 d后	t
对照组	15.44±7.74	9.56±2.39	4.997^＊＊	14.65±4.88	10.33±2.07	5.512^＊＊	51.56±8.59	43.15±3.92	6.614^＊＊
观察组	15.75±7.88	7.23±2.41	7.583^＊＊	14.85±4.95	7.96±2.65	8.562^＊＊	51.35±8.56	30.15±3.77	15.493^＊＊
t	0.188	4.736^＊＊		0.199	4.902^＊＊		0.125	16.561^＊＊