Study On The Effectiveness Of Non-invasive Positive Pressure Ventilation In The Treatment Of OSAHS-related

Objective:This study analyzed the relevant clinical indicators before and after non-invasive positive pressure ventilation in patients with OSAHS-related hypertension to explore the efficacy of non-invasive positive pressure ventilation in the treatment of OSAHS-related hypertension.Methods:Collected patients who were hospitalized in the General Medicine Department and Hypertension Clinic of Yan’an Hospital Affiliated to Kunming Medical University from June 2017 to May 2020.According to the inclusion criteria,60 patients with OSAHS-related hypertension who were diagnosed and completed follow-up were selected as the research objects.Among them,29 cases were in the treatment group(antihypertensive drugs+non-invasive positive pressure ventilation),and 31 cases were in the control group(antihypertensive drugs).(1)Record and analyze the relevant clinical indicators of the two groups of patients before and after treatment,and explore the efficacy of non-invasive positive pressure ventilation in the treatment of OSAHS-related hypertension.(2)The 29 patients in the treatment group were divided into non-severe group(n=6)and severe group(n=23)according to sleep apnea hypopnea index(AHI),and divided into non-obese group according to body mass index(BMI)(n=12)and obesity group(n=17),according to the duration of non-invasive positive pressure ventilation treatment,divided into≤6 months group(n=5)and>6 months group(n=24),and the relevant clinical indicators were divided into groups within the group.Before and after comparison and comparison between groups,observe the difference in curative effect of non-invasive positive pressure ventilation between each group.The related indicators recorded include:①Epworth Sleepiness Scale(ESS)score),sleep apnea-hypopnea index(AHI),minimum blood oxygen saturation(LSaO2)and average blood oxygen saturation(SpO2);②Experiment Laboratory related information:red blood cells(HBC),hemoglobin(HBG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),blood creatinine(sCr),uric acid(UA),total cholesterol(CHOL),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HLD-C),fasting blood glucose(FPG),blood sodium(Na),Serum potassium(K);③Blood pressure,heart rate and arterial elasticity related indicators:office systolic blood pressure(SBP),office diastolic blood pressure(DBP),average systolic blood pressure(24hSBP),average diastolic blood pressure(24hDBP),Daytime average systolic blood pressure(dSBP),daytime average diastolic blood pressure(dDBP),night average systolic blood pressure(nSBP),night average diastolic blood pressure(nDBP),daytime average HR,night average HR,ankle brachial index(ABI),ankle-brachial pulse Wave propagation velocity(baPWV).Results:1.The AHI,ESS scores,SBP,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,and average HR at night in the treatment group were lower than before treatment(P<0.05),LSaO2,average SpO2,HDL-C were lower than before treatment Increased(P<0.05),and the difference in other indicators was not statistically significant(P>0.05);SBP,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,and night-time average HR of patients in the control group were lower than before treatment(P<0.05))HGB and RBC were higher than before treatment(P<0.05),and the difference in other indexes was not statistically significant(P>0.05).The change rates of related indicators before and after treatment were compared between the two groups of patients.The improvement of AHI,LSaO2,average SpO2 and ESS scores of patients in the treatment group was better than that of the control group(P<0.05),and the difference in other indicators was not statistically significant(P>0.05).2.There was no statistically significant difference in related indicators in the non-severe group before and after treatment(P>0.05);in the severe group,the AHI,ESS score,SBP,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,night average HR were more significant.Decrease before treatment(P<0.05),LSaO2,average SpO2,BUN,HDL-C increased compared with before treatment(P<0.05),and the difference in other indicators was not statistically significant(P>0.05).The change rates of related indicators before and after treatment were compared between the two groups of patients.The decline rates of 24hSBP,dSBP,dDBP,nSBP,and nDBP in the severe group were higher than those in the non-severe group(P<0.05),and the differences in other indicators were not statistically significant(P>0.05)).3.AHI,ESS score,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP in the non-obese group were lower than before treatment(P<0.05),and the average SpO2 was higher than before treatment(P<0.05),and there was no difference in other indicators Statistical significance(P>0.05);AHI,ESS score,SBP,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,night average HR,baPWV in obese patients decreased compared with before treatment(P<0.05),LSaO2 SpO2 was higher than before treatment(P<0.05),and the difference in other indexes was not statistically significant(P>0.05).Comparing the change rate of related indicators before and after treatment between the two groups of patients,the increase rate of LSaO2 in the obese group was higher than that in the non-obese group(P<0.05),and the differences in other indicators were not statistically significant(P>0.05).4.AHI,LDL-C,CHOL,baPWV of patients in the≤6 months group were lower than before treatment(P<0.05),LSaO2 was higher than treatment(P<0.05),and the difference in other indicators was not statistically significant(P>0.05);>AHI,ESS score,DBP,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,and average nighttime HR of patients in the 6-month group were lower than before treatment(P<0.05),LSaO2 was higher than before treatment(P<0.05),and other indicators were different No statistical significance(P>0.05).The change rates of related indicators before and after treatment were compared between the two groups of patients,and the differences were not statistically significant(P>0.05).Conclusions:1.Non-invasive positive pressure ventilation can significantly reduce the AHI and ESS scores of patients with OSAHS-related hypertension,and improve night hypoxia.2.Non-invasive positive pressure ventilation can significantly reduce the nighttime blood pressure and nighttime average HR in patients with OSAHS-related hypertension,increase the level of HDL-C,and is particularly effective for patients with severe OSAHS.3 Non-invasive positive pressure ventilation can also improve arterial elasticity in obese OSAHS-related hypertension patients.4.The duration of non-invasive positive pressure ventilation may be an important indicator to improve night blood pressure and heart rate.