OBJECTIVE: To investigate the therapeutic effect of nasal continuous positive airways pressure (nCPAP) combined with antireflux medicine on obstructive sleep apnea hypopnea syndrome (OSAHS) with gastroesophageal reflux (GER). METHOD: Sixty patients with moderate to severe OSAHS with GER were simultaneously received PSG and esophageal pH monitoring and randomly divided into control group and treatment group with each group 30 patients. The control group were simply received nCPAP for every night. The treatment group were received the same treatment and combined antireflux medicine, with esomeprazole 40 mg/d and mosapride citrate 5 mg, 3 times a day,oral. Both the groups symptomatic status of OSAHS and GER were observed on the third day and the 14th day during therapy, and then the same tests above were repeated on the 14th day. RESULT: Compared with the control group, the symptomatic improvement rate of OSAHS on the third day and 14th day during therapy,the symptomatic improvement rate of GER on the third day during therapy were increased with statistical significance in the treatment group (P<0.05), however, the difference of symptomatic improvement rate of GER between the two groups on the 14th day during therapy did not have statistical significance (P>0.05). Compared with those of the control group on the 14th therapeutic night, AHI, LSaO2, the percentage of time with pH<4, the longest reflux duration,reflux episodes and DeMeester scoring did not have statistical significance in the treatment group (P>0.05). CONCLUSION nCPAP is the most effective method for patients suffering OSAHS associated with GER, but nCPAP used in conjunction with anti-reflux drugs do not improve efficacy.
Adult ; Continuous Positive Airway Pressure ; Female ; Gastroesophageal Reflux ; complications ; therapy ; Gastrointestinal Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; complications ; therapy

Objective:To investigate the clinical features and prognosis of patients with corona virus disease 2019 (COVID-19).Methods:The clinical data and chest computed tomography (CT) results of 496 patients with COVID-19 admitted to Wuhan No.7 Hospital from January 22 to February 24, 2020 were retrospectively analyzed. The nucleic acid of 2019 novel coronavirus (2019-nCoV) was detected by real-time fluorescence reverse transcription polymerase chain reaction.Results:There were 246(49.6%) males and 250(50.4%) females. The patients ranged from 10 to 91 years old. All of the patients had a history of living in Wuhan City or close contact with diagnosed patients. The detection of nucleic acid of 2019-nCoV in 496 patients were all positive, and one patient was recuperation positive 14 days after cured and discharged. There were 13 mild cases, 101 ordinary cases, 337 severe cases and 45 critical cases. Twelve (2.4%) patients were asymptomatic, 417(84.1%) patients had fever, and 67(13.5%) had normal body temperature. Other major symptoms included dry cough (229 cases (46.2%)), fatigue (129 cases (26.0%)), short breath (77 cases (15.5%)), expectoration (86 cases (17.3%)), dyspnea (43 cases (8.7%)), chest pain (11 cases (2.2%)) and diarrhea (86 cases (17.3%)). Seventy-five cases (15.1%) showed decreased peripheral blood white blood cell counts and 305 cases (61.5%) showed decreased lymphocyte proportions. Serum alanine aminotransferase and aspartate aminotransferase elevations were presented in 91 cases (18.3%) and 176 cases (35.5%), respectively. Infiltrates on chest CT were seen in 483 cases (97.4%), with 68.7%(332/483) in both lungs, 20.3%(98/483) in right lung, 11.0%(53/483) in left lung. No infiltrates on chest CT were seen in 13(2.6%) patients. As of February 24, 2020, 120(24.2%) patients were cured and discharged, 102(20.6%) patients improved, 52(10.5%) patients died, and the remaining patients were still under treatment. Among the dead patients, 16 cases (30.8%) aged from 61 to 70 years old, 32 cases (61.5%) aged≥71 years old, and 38 cases (73.1%) had underlying diseases.Conclusions:The COVID-19 lesions mainly involve both lungs. The main clinical features are fever and dry cough. The CT imaging findings of the lungs are mostly frosted hyaline. Peripheral white blood cell and leukomonocyte counts are decreased or normal. Older individuals with underlying diseases have increased risk of death.