内科

目的探讨双水平无创正压通气联合硝苯地平缓释片治疗高血压合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的临床效果。方法选取2013年6月至2016年6月我院收治的高血压合并阻塞性睡眠呼吸暂停低通气综合征患者136例作为研究对象，按随机数字表法分为对照组和观察组，每组68例。对照组患者给予硝苯地平缓释片进行治疗；观察组患者在对照组治疗的基础上给予双水平无创正压通气治疗。比较两组患者的临床疗效、血压水平、睡眠质量以及不良反应发生情况。结果观察组患者治疗总有效率（97.06%）显著高于对照组（83.82%）、观察组患者临床疗效优于对照组（P＜0.05）；治疗后，两组患者夜间平均收缩压(nMSP)、夜间平均舒张压(nMDP)、白天平均收缩压（dMSP）、白天平均舒张压（dMDP）均显著下降（P＜0.05）；观察组患者nMSP、nMDP、dMSP、dMDP低于对照组（P＜0.05或0.01）。治疗后，两组患者AHI及最长呼吸暂停时间均降低、最低血氧饱和度均升高（P＜0.05）；观察组患者AHI及最长呼吸暂停时间小于对照组、最低血氧饱和度高于对照组（P＜0.05或0.01）。结论双水平无创正压通气联合硝苯地平缓释片治疗高血压合并阻塞性睡眠呼吸暂停低通气综合征患者，可有效改善夜间呼吸暂停和低通气现象，维持血压稳定，临床疗效显著，值得推广使用。

ObjectiveTo explore the clinical effect of bi-level noninvasive positive pressure ventilation combined with extended release nifedipine tablets in treatment of patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome. MethodsA total of 136 cases of patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome in our hospital from June 2013 to June 2016 were selected and randomly divided into control group and observation group, with 68 cases in each group. The control group was treated with extended release nifedipine tablets, and the observation group was treated with bi-level noninvasive positive pressure ventilation on the basis of extended release nifedipine tablets. Curative effect, blood pressure levels, sleep quality, and adverse reactions were compared between the two groups. ResultsThe total effective rate of the observation group (97.06%) was significantly higher than that of the control group (83.82%), and the clinical efficacy in the observation group was significantly superior to that in the control group (P＜0.05). The nocturnal mean systdic pressure (nMSP), nocturnal mean diastolic pressure (nMDP), diurnal mean systolic pressure (dMSP) and diurnal mean diastolic pressure (dMDP) in the two groups were significantly decreased compared to those before treatment, and the indexes mention above in the observation group were significantly lower than those in the control group (P＜0.05). Compared with those before treatment, apnea hypopnea index (AHI) and longest apnea time were significantly decreased, and the lowest oxygen saturation was significantly increased after treatment (P＜0.05); apnea hypopnea index (AHI) and longest apnea time of the observation group were significantly lower than those of the control group, and the lowest oxygen saturation of the observation group was significantly higher than that of the control group (P＜0.05 or ＜0.01). ConclusionsBi-level noninvasive positive pressure ventilation combined with extended release nifedipine tablets in treatment of patients with hypertension complicated with obstructive sleep apnea hypopnea syndrome has a significant effect, which can effectively improve the nocturnal apnea and low ventilation, and maintain stable blood, which is worthy of clinical application.