【摘要】 目的探讨家庭双水平气道正压通气（BiPAP）治疗重叠综合征（OS,慢性阻塞性肺疾病-睡眠呼吸暂停低通气综合征）3个月的疗效。方法随机入选2014年7月²016年9月本院门诊就诊的符合入选标准的OS患者44例,随机分为两组:对照组22例和试验组22例,对照组给予常规治疗,包括行为干预治疗及常规药物治疗,试验组在常规治疗基础上加用每天夜间8h的BiPAP治疗。对两组患者治疗1、3个月后进行门诊随访,比较两组患者治疗1、3个月后疗效指标:呼吸困难评分（mMRC）、嗜睡评分量表（ESS）、多导睡眠监测指标（睡眠紊乱指数AHI、夜间最低氧饱和度minSPO₂）、晨起血气分析指标（PO₂、PCO₂）及3个月内慢性阻塞性肺疾病（COPD）急性加重次数的差异。结果两组患者均能耐受相关治疗,无一例脱失;常规治疗及BiPAP治疗均能改善患者1、3个月mMRC评分、ESS评分、AHI、minSPO₂、晨起PO₂和PCO₂指标（P<0.05）。与常规治疗组相比,随着治疗时间延长,BiPAP治疗更能改善mMRC评分、ESS评分、AHI、minSPO₂、晨起PCO₂指标。两组患者3个月内COPD急性加重的次数差异无统计学意义（P>0.05）。结论家庭BiPAP治疗可行性良好,可显著逐渐改善患者3个月的预后,值得在OS患者中推广应用。更多还原

【Abstract】 Objective To investigate the clinical effect of 3 months of family BiPAP therapy on COPD-OSAHS Overlapsyndrome（OS） patients. Methods Forty four OS outpatients of our hospital from Jul 2014 to Sep 2016 were recruited and randomly divided into 2 groups:control group（n=22） and trial group（n=22）.Patients in the control group was given general therapy,included behavior intervention and regular medication therapy.Patients in the trial group was given BiPAP treatment of 8 h at nigh on the basis of routine treatment. The patients were asked to attend the outpatient clinic after 1 month and 3 months.and complete the associated tests. efficacy indexes [dyspnea symptom score（mMRC）,Epworth sleepiness scale（ESS）,the apnoea hyponea index（AHI）,the lowest sleep SpO₂（minSPO₂）,blood gas analysis in the morning（PO₂,PCO₂） and the times of acute exacerbation of COPD] between two groups after 1 month and 3 months were compared. Results All the patients were completed the 3 months follow-up and compliance with the treatment.mMRC score,ESS score,AHI、minSPO₂、PO₂ and PCO₂ were all improved in both groups after treatment（P < 0.05）.mMRC score,ESS score,AHI、minSPO₂ and PCO₂ were significant improved in trail group than control group.There was no significant difference in number of acute attack of COPD between the two groups（P > 0.05）.Conclusion Family BiPAP therapy has good feasibility,and can improve the outcomes of OS patients.It is worth using widely in patients with OS.更多还原