Chest:阻塞型睡眠呼吸暂停是静脉血栓栓塞复发的危险因素

2016-12-26 haofan MedSci原创

首次PE后,OSA是PE复发或因新的血栓栓塞事件重新开始口服抗凝药治疗的一个独立的危险因素。

阻塞型睡眠呼吸暂停(OSA)是首次发生肺栓塞(PE)的危险因素之一,但是其对血栓栓塞复发风险的影响还不确定。近日,呼吸疾病领域权威杂志Chest杂志上发表了一篇研究文章,旨在探讨首次发作的PE患者停用口服抗凝药后OSA的预测血栓栓塞复发的价值。

在连续就诊的120例首次发作的PE后停用口服抗凝药的患者中,研究人员对这些患者进行了家庭呼吸多道描记和睡眠特点记录,并对PE已知的危险因素和血压、肺功能参数、体力活动、D-二聚体水平和凝血酶原片段1+2(F1+2)进行了测量。研究人员对这些患者随访了5~8年,主要终点为PE复发。次要终点为任何血栓栓塞事件导致的重新开始口服抗凝药治疗。

随访期间共有19例患者出现PE复发,其中16人有呼吸暂停低通气指数(AHI)≥10h–1。在多因素Cox回归模型中,AHI≥10h–1(风险比[HR]为20.73;95%可信区间[CI]为1.71-251.28)、平均夜间氧饱和度(nSao2)(HR为0.39;95%CI为0.20-0.78)、血氧饱和度<90%的时间(CT90%)(HR为0.90;95%可信区间为0.82-0.98)和D-二聚体水平(HR为1.001;95%可信区间为1.00-1.002)被确定为PE复发的独立危险因素。


24例重新开始口服抗凝药治疗的患者中,AHI≥10 h–1(HR为20.66;95%CI为2.27-188.35)、平均nSao2(HR为0.54;95%CI为0.32-0.94)、Epworth睡眠量表(ESS)(HR为0.73;95%CI为0.56-0.97)仍可作为重新开始口服抗凝药治疗的独立危险因素。

由此可见,首次PE后,OSA是PE复发或因新的血栓栓塞事件重新开始口服抗凝药治疗的一个独立的危险因素。

原始出处:

Alberto Alonso-Fernández, et al. OSA Is a Risk Factor for Recurrent VTE. Chest.December 2016. 

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    2017-11-25 xue8602
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1989029, encodeId=28b31989029d6, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Sat Oct 21 02:53:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955261, encodeId=3537195526186, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Nov 25 09:53:00 CST 2017, time=2017-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050575, encodeId=4d2f20505e560, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Mar 23 05:53:00 CST 2017, time=2017-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1980684, encodeId=064f19806840e, content=<a href='/topic/show?id=935b99181bd' target=_blank style='color:#2F92EE;'>#静脉血栓栓塞复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99181, encryptionId=935b99181bd, topicName=静脉血栓栓塞复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3e9205, createdName=tidiq, createdTime=Tue Jun 13 16:53:00 CST 2017, time=2017-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696693, encodeId=9971169669375, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Wed Feb 22 04:53:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697406, encodeId=cc92169e4066f, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Nov 11 10:53:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929265, encodeId=865919292657d, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sat Aug 05 11:53:00 CST 2017, time=2017-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596480, encodeId=623a159648095, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Wed Dec 28 07:53:00 CST 2016, time=2016-12-28, status=1, ipAttribution=)]
    2017-02-22 tomyang96
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    2017-11-11 fusion
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    2017-08-05 Smile2680
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