科研之友
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摘要
Continuous positive airway pressure (CPAP) is the therapy of choice for the treatment of obstructive sleep apnea (OSA). Not all patients can use CPAP therapy with adequate compliance. There is a need to develop more comfortable modes. Auto bi-level Pressure Relief-Positive Airway Pressure (ABPR-PAP) can be an alternative. We conducted a prospective double-blind, randomised trial to evaluate the efficacy and compliance of ABPR-PAP compared with CPAP in OSA patients. We included 35 CPAP naive patients (age 53.3 +/- 10.3 years, BMI 31.0 +/- 5.0 kg/m(2), ESS 10.0 +/- 4.2) diagnosed with moderate to severe OSA who underwent a successful CPAP titration. Patients were randomised into the CPAP or the ABPR-PAP treatment group. We used the same device (BIPAPA (R) Auto, Philips Respironics) for CPAP or ABPR-PAP. Apnea-hypopnea index (AHI) was determined using polysomnography before (AHI 40.6 A +/- 18.3 per hour) and after treatment. Eighteen patients received CPAP and the remaining 17 received APBR-PAP. Groups were similar in terms of demographics and OSA severity. There were no serious adverse events during the trial. CPAP was fixed by a sleep expert and ABPR-PAP varied (range 5-15 cmH(2)O). AHI decreased in the CPAP group to 6.4 +/- 5.7 per hour and in the ABPR-PAP group to 4.8 +/- 3.6 per hour in the first night (N = 35). After 3 months, the AHI decreased in the CPAP group to 4.4 +/- 5.3 per hour and in the ABPR-PAP group to 2.6 +/- 3.8 per hour (N = 32). Differences between the groups were not statistically significant. There were no differences in compliance. ABPR-PAP is a promising new ventilation mode that enables effective treatment of OSA patients.
- 出版日期2012-9
