山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 131-137.doi: 10.6040/j.issn.1673-3770.0.2018.446
陈淳1,丁健1,谢晋2
CHEN Chun1, DING Jian1, XIE Jin2
摘要: 目的 阻塞性睡眠呼吸暂停低通气综合征(OSAS)可致全身炎症反应,是心血管疾病的一个独立危险因素,持续气道正压通气治疗(CPAP)已被证明可改善血清炎症标志物水平。研究通过对历年文献进行系统的荟萃分析,评估CPAP治疗对OSAS患者炎症标志物水平的影响。 方法 在PubMed、EMBASE和Cochrane图书馆检索系统检索英文文献,均以成人为研究对象,每项研究至少包含≥1个炎症标志物治疗前后的水平变化。OSAS定义为睡眠呼吸暂停低通气指数(AHI)≥5/h,用标准均数差(SMD)评估CPAP治疗是否降低炎症标志物水平。 结果 共筛选出1 128项研究报道,其中27项纳入分析。C反应蛋白(CRP)有17篇文献共895例患者;肿瘤坏死因子-α(TNF-α)有10篇文献共290例患者纳入研究。统计发现CPAP治疗前后OSAS患者血清CRP水平差异具有统计学意义(Z=4.55,P<0.00001,SMD 0.86,95% CI:0.49-1.23),CPAP治疗前后TNF-α水平变化差异无统计学意义(Z=1.92,P=0.05,SMD 1.08,95% CI:0.02-2.18)。 结论 长期CPAP治疗可降低OSAS患者血清CRP水平,而血清TNF-α水平无明显下降。CPAP治疗能够有效改善全身炎症反应,预防心血管疾病的进展。
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