Eur Respir J:CPAP治疗对阻塞性睡眠呼吸暂停合并冠状动脉疾病患者结局的影响!

2017-12-12 xing.T MedSci原创

由此可见,采用CPAP治疗的OSA合并CAD患者与无OSA的患者相比MACCEs的风险并未增加。

冠状动脉疾病(CAD)同时伴有阻塞性睡眠呼吸暂停(OSA)患者相比于无OSA的CAD患者发生主要不良心脑血管事件(MACCEs)的风险增加。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员旨在明确OSA患者接受治疗时,两组患者的风险是否相似。

该研究为RICCADSA随机对照试验的平行观测组,是在2005年至2013年之间瑞典进行的。接受血管重建的CAD且白天嗜睡(Epworth嗜睡量表评分≥10)的OSA(呼吸暂停低通气指数(AHI)≥15次事件每小时)患者提供持续气道正压通气(CPAP)(n=155);无OSA(AHI<5 次事件每小时)的CAD患者作为对照者(n=112),因为将嗜睡的OSA患者不进行治疗在伦理道德上不可行。该研究的主要终点是患者首次MACCEs事件。中位随访时间为57个月。

OSA患者MACCEs的发生率为23.2%,而无OSA的患者为16.1%(调整后的风险比为0.96,95%可信区间为0.40-2.31;P=0.923)。年龄、既往血管重建与MACCEs风险增加相关,而基线时冠状动脉旁路移植术与风险降低相关。

由此可见,采用CPAP治疗的OSA合并CAD患者与无OSA的患者相比MACCEs的风险并未增加。

原始出处:


Yüksel Peker,et al. Outcomes in coronary artery disease patients with sleepy obstructive sleep apnoea on CPAP. Eur Respir J. http://erj.ersjournals.com/content/50/6/1700749

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    2017-12-16 tomyang96
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    2017-12-14 半夏微凉

    学习了谢谢分享

    0

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对于OHS患者,中期NIV治疗比CPAP和生活方式能更有效地改善肺动脉高压、左心室肥厚和功能结局,需要长期研究来证实这些结果。

Eur Respir J:24h动态血压监测对接受CPAP治疗的OSA患者有何价值?

该研究的结果表明,夜间高血压、血压昼夜模式和夜间心率可能是CPAP治疗血压反应的预测因子,这些结果支持对OSA患者在CPAP治疗开始前进行24小时动态血压监测。

AJRCCM:CPAP不改变OSA,CVD共存的肾功能

根据7月25日发表在《美国呼吸与危重病医学杂志》上的一项研究,对于患有阻塞性睡眠呼吸暂停综合症(OSA)和心血管疾病的人来说,持续的正气道压力(CPAP)不会改变肾功能。阻塞性睡眠呼吸暂停(OSA)与肾功能受损有关,但OSA治疗是否会影响肾功能存在不确定性。为了探讨持续正气道压力(CPAP)对共同存在的OSA和心血管疾病患者肾功能的影响。澳大利亚弗林德斯大学的Kelly A. Loffler博士及

Eur Respir J:持续气道正压通气对睡眠呼吸暂停的女性患者血压和代谢的影响!

由此可见,在中重度女性OSA患者中,与保守治疗相比,12 周CPAP治疗可以改善血压,尤其是舒张压,但是不改变代谢指标。

Eur Heart J:持续气道正压通气治疗在预防OSA患者心血管事件中的作用!

在夜间CPAP使用超过4小时的患者中CPAP治疗可能会降低MACE和卒中的风险。需要额外的随机试验强制要求CPAP治疗时间来证实这一效果。