摘要目的:探讨高压氧（HBO）联合无创正压通气（NPPV）对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者睡眠结构及血清白细胞介素-6（IL-6）、C-反应蛋白（CRP）、丙二醛（MDA）水平的影响。方法:选取2019年1月至2021年9月济宁医学院附属医院呼吸与危重症医学科收治的106例OSAHS患者作为研究对象，按照随机数字表法分为HBO组（单纯HBO治疗， n=35）、NPPV组（单纯NPPV治疗， n=35）、联合组（HBO联合NPPV治疗， n=36）。于治疗前和治疗1个月后观察患者睡眠结构、呼吸暂停低通气指数（AHI）、低通气指数（HI）、呼吸暂停指数（AI）、最低血氧饱和度（LSaO 2）、血清MDA、IL-6、CRP水平变化及临床症状改善情况。 结果:治疗前，3组患者的睡眠结构、AHI、AI、HI、LSaO 2、IL-6、CRP、MDA比较差异无统计学意义（ P>0.05）；治疗后，3组患者的睡眠结构、AHI、AI、HI、LSaO 2、IL-6、CRP、MDA比较差异具有统计学意义（ P<0.05）；联合组患者的睡眠转换次数、Ⅰ期和Ⅱ期百分比、AHI、AI、HI、IL-6、CRP、MDA均低于HBO组、NPPV组，而Ⅲ+Ⅳ期、快速眼动睡眠（REM）期百分比、LSaO 2均高于HBO组、NPPV组（ P<0.05）。治疗后，联合组患者的白天嗜睡、晨起口干、夜间憋醒、睡眠打鼾占比均低于HBO组、NPPV组（ P<0.05）。 结论:HBO联合NPPV治疗OSAHS效果显著，有利于改善患者的睡眠结构，降低血清IL-6、CRP、MDA水平。

abstractsObjective:To explore the effects of hyperbaric oxygen（HBO）combined with noninvasive positive pressure ventilation（NPPV）on sleep structure and levels of serum interleukin-6（IL-6），C-reactive protein（CRP），and malondialdehyde（MDA）in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods:A total of 106 patients with OSAHS admitted to the Department of Respiratory and Critical Care Medicine，Affiliated Hospital of Jining Medical University from January 2019 to September 2021，were selected as the research objects. According to the random number table method，those patients were divided into HBO group（treated with HBO only， n=35），NPPV group（treated with NPPV only， n=35）and combination group（treated with HBO combined with NPPV， n=36）. The improvement of clinical symptoms，such as changes of sleep structure，apnea hypopnea index（AHI），hypopnea index（HI），apnea index（AI），lowest blood oxygen saturation（LSaO 2），levels of serum malonaldehyde（MDA），IL-6，and CRP were observed before treatment and one month after treatment. Results:Before treatment，there were no significant difference in sleep structure，AHI，AI，HI，LSaO 2，IL-6，CRP，and MDA among three groups（ P>0.05）. After treatment，there were significant differences in sleep structure，AHI，AI，HI，LSaO 2，IL-6，CRP，and MDA among three groups（ P<0.05）. The sleep conversion times，the percentages of stage Ⅰ and stage Ⅱ，AHI，AI，HI，IL-6，CRP，and MDA in the combination group were lower than those in the HBO group and the NPPV group，while the percentages of Ⅲ+Ⅳ stage and REM stage，and LSaO 2 were higher than those in the HBO group and the NPPV group（ P<0.05）. After treatment，the proportions of drowsiness in daytime，dry mouth in the morning，waking up at night due to obstruction，and snoring during sleep in the combination group were lower than those in the HBO group and the NPPV group（ P<0.05）. Conclusion:HBO combined with NPPV has a significant curative effect in the treatment of OSAHS，which is conducive to improving sleep structure and reducing the levels of serum IL-6，CRP，and MDA.