The effect of different non-invasive positive airway pressure ventilation on inflammatory factors in elderly patients with OS
Ou Min
Zhang Chao
Fang Tingzheng
Abstract：Objective To investigate the effects of Bi-level positive airway pressure(BIPAP)and single level continuous positive airway pressure(CPAP)on inflammatory factors in elderly patients with overlap syndrome(OS),namely obstructive sleep apnea hypopnea syndrome(OSAHS)combined with chronic obstructive pulmonary disease(COPD).Methods 122 elderly patients with severe OSAHS and mild to moderate stable COPD admitted to our hospital from June 2016 to January 2020 were selected and randomly divided into BIPAP group and CPAP group,with 61 patients in each group.The apnea hypopnea index(AHI),apnea time,night mean oxygen saturation(M-SaO2),night minimum oxygen saturation(L-SaO2),inflammatory factors interleukin 33(IL-33),soluble matrix lysin(sST2),tumor necrosis factor-α(TNF-α)and Endothelin 1(ET-1)were monitored before and 3 weeks after treatmentrespectively.Results After treatment,AHI,apnea time in both groups were significantly lower than before treatment,M-SaO2 and L-SaO2 increased compared to before treatment,with a statistically significant difference(P<0.01).And after treatment,the decrease of AHI,apnea time in the BIPAP group were significantly better than that of the CPAP group[(10.95±2.81)vs.(12.18±2.98),(15.93±6.97)s vs.(18.92±7.23)s],and the increase of M-SaO2 and L-SaO2 were better than that of the CPAP group[(94.82±12.69)%vs.(90.01±13.97)%,(89.56±11.13)%vs.(85.70±10.25)%],with a statistically significant difference(t = 2.35,2.33,1.99,1.99,P<0.05).After treatment,IL-33,sST2,TNF-α and ET-1 in both groups were significantly lower than before treatment,with a statistically significant difference(P<0.01).And the decrease of IL-33,sST2,TNF-α in the BIPAP group were significantly better than that of the CPAP group[(30.27±4.97)pg/ml vs.(32.01±5.51)pg/ml,(0.57±0.19)ng/ml vs.(0.62±0.17)ng/ml,(31.31±6.07)pg/ml vs.(33.54±5.11)pg/ml,(46.99±7.33)pg/ml vs.(49.77±6.15)pg/ml],with a statistically significant difference(t = 1.99,1.99,2.20,2.27,P<0.05).AHI showed a highly positive correlation with IL-33,sST2,TNF-α and ET-1(r=0.79,0.84,0.86,0.80,P<0.05).All cases showed no significant adverse reactions.Conclusion BIPAP and CPAP have definite therapeutic effects and good safety in the treatment of elderly OS.Furthermore,BIPAP and CPAP can reduce the inflammatory factors of elderly OS.The BIPAP group has a more significant effect.The use of BIPAP ventilator treatment may be a better choice.
Keywords：Obstructive sleep apnea hypopnea syndromeChronic obstructive pulmonary diseaseOverlap syndromeBi-level positive airway pressure ventilationSingle level continuous positive airway pressure ventilation
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 638-641 )