Asian Pac J Allergy Immunol:鼻内皮质激素治疗中度到重度阻塞性睡眠呼吸暂停且并发慢性鼻炎患者的效果研究

2020-09-06 AlexYang MedSci原创

慢性鼻炎与阻塞性睡眠呼吸暂停(OSA)是常见的并存疾病。目前关于鼻内类固醇疗效的证据很少。最近,有研究人员评估了鼻内类固醇对中重度OSA且并存慢性鼻炎的疗效。

慢性鼻炎与阻塞性睡眠呼吸暂停(OSA)是常见的并存疾病。目前关于鼻内类固醇疗效的证据很少。最近,有研究人员评估了鼻内类固醇对中重度OSA且并存慢性鼻炎的疗效。

研究人员进行了一个前瞻性随机、双盲和安慰剂对照试验。研究人员将患者随机接受鼻内类固醇(糠酸氟替卡松,110 mcg/天)或安慰剂治疗,并为期一个月。主要终点是呼吸暂停低通气指数(AHI)的变化。研究共有34名患者,并随机分配进行鼻内类固醇治疗(N=18)或安慰剂(N=16)治疗。调整后的AHI绝对差异均值变化没有显示出明显差异(11.5±7.9事件/小时[95% CI;-4.9至27.8;p=0.16])。另外,研究人员在鼻内类固醇组中观察到非上呼吸紊乱指数(RDI)显著减少(56.1±21.9事件/小时[95%CI;18.9至93.2;P=0.01])。组内比较发现只有鼻内类固醇组在接受药物后表现出AHI、RDI、NREM RDI、TNSS和泰国匹兹堡睡眠质量指数的显著降低(分别为p=0.02、0.02、0.01、0.003和<0.001)。

安慰剂组和鼻内类固醇组的AHI均差比较

最后,研究人员指出,在中度至重度且并存慢性鼻炎的OSA患者中,鼻内类固醇能够明显减少非睡眠期间的阻塞性呼吸事件。因此,鼻内类固醇可考虑作为OSA治疗的辅助或替代手段。

原始出处:

Vorakamol Phoophiboon, Kiat Ruxrungtham, Dittapol Muntham et al. A randomized, double-blind, placebo-controlled trial on the effect of intranasal corticosteroid as a treatment for moderate to severe obstructive sleep apnea with coexisting chronic rhinitis. Asian Pac J Allergy Immunol. Aug 2020

 

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    2020-11-20 丁鹏鹏
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topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Fri Nov 20 21:15:02 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989160, encodeId=23cb19891607e, 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=32, 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=Sun Jun 20 09:15:02 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1780114, encodeId=4e871e8011454, content=<a href='/topic/show?id=10d62860dd' target=_blank style='color:#2F92EE;'>#ASIA#</a>, beContent=null, 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content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509849, encodeId=2ae615098493a, content=<a href='/topic/show?id=8fc053e3768' target=_blank style='color:#2F92EE;'>#慢性鼻炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53737, encryptionId=8fc053e3768, topicName=慢性鼻炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6d2a10156443, createdName=fyxzlh, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596603, encodeId=668615966033e, 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=27, 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=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600419, encodeId=f4351600419e9, content=<a href='/topic/show?id=3565e21649e' target=_blank style='color:#2F92EE;'>#皮质激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72164, encryptionId=3565e21649e, topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883247, encodeId=a19188324ebb, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Mon Sep 07 08:12:51 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-16 luwei00
  5. [GetPortalCommentsPageByObjectIdResponse(id=1956460, encodeId=d08019564609e, content=<a href='/topic/show?id=b9292862f3' target=_blank style='color:#2F92EE;'>#Asian#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2862, encryptionId=b9292862f3, topicName=Asian)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Fri Oct 16 21:15:02 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758282, encodeId=938c1e5828210, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, 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content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509849, encodeId=2ae615098493a, content=<a href='/topic/show?id=8fc053e3768' target=_blank style='color:#2F92EE;'>#慢性鼻炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53737, encryptionId=8fc053e3768, topicName=慢性鼻炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6d2a10156443, 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encryptionId=3565e21649e, topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883247, encodeId=a19188324ebb, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Mon Sep 07 08:12:51 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1956460, encodeId=d08019564609e, content=<a href='/topic/show?id=b9292862f3' target=_blank style='color:#2F92EE;'>#Asian#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2862, encryptionId=b9292862f3, topicName=Asian)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Fri Oct 16 21:15:02 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758282, encodeId=938c1e5828210, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, 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content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509849, encodeId=2ae615098493a, content=<a href='/topic/show?id=8fc053e3768' target=_blank style='color:#2F92EE;'>#慢性鼻炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53737, encryptionId=8fc053e3768, topicName=慢性鼻炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6d2a10156443, createdName=fyxzlh, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596603, encodeId=668615966033e, 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=27, 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=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600419, encodeId=f4351600419e9, content=<a href='/topic/show?id=3565e21649e' target=_blank style='color:#2F92EE;'>#皮质激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72164, encryptionId=3565e21649e, topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Sep 08 11:15:02 CST 2020, time=2020-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883247, encodeId=a19188324ebb, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Mon Sep 07 08:12:51 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-08 膀胱癌
  7. [GetPortalCommentsPageByObjectIdResponse(id=1956460, encodeId=d08019564609e, content=<a href='/topic/show?id=b9292862f3' target=_blank style='color:#2F92EE;'>#Asian#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2862, encryptionId=b9292862f3, topicName=Asian)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Fri Oct 16 21:15:02 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758282, encodeId=938c1e5828210, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, 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    2020-09-07 14818eb4m67暂无昵称

    学习

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Am J Resp Crit Care:减肥对阻塞性睡眠呼吸暂停严重程度的影响

接受ILI减肥的OSA和2型糖尿病参与者在治疗10年时降低了OSA严重程度。ILI和DSE组在10年时OSA严重程度无差异。

Eur Respir J:轻度至中度阿尔茨海默氏病患者阻塞性睡眠呼吸暂停和认知功能下降

该研究可观察到OSA组的ADAS-cog评分比非OSA组更好,虽有统计学意义,但无临床意义。随访1年后,研究人员在不同的认知亚领域或总体认知方面均未发现差异。

Eur Respir J:阻塞性睡眠呼吸暂停治疗与血压的关系

尽管该荟萃分析显示,CPAP/MAD预期的降血压效应为中等,但它确定了可以预测CPAP在血压控制方面可明显受益的患者特征。这些发现应谨慎解释,但是在确定OSA治疗患者与BP降低相关的潜在特征时,它们尤其重要。

Diabetes Care:阻塞性睡眠呼吸暂停合并心血管疾病患者持续气道正压治疗、血糖与糖尿病风险

在已确诊的心血管疾病和阻塞性睡眠呼吸暂停患者中,该研究并未发现CPAP治疗对糖尿病或糖尿病前期或糖尿病风险患者的血糖控制有影响。

Hypertension:高血压患者慢波睡眠与阻塞性睡眠呼吸暂停之间的相互作用

由此可见,SWS的效应很可能受到OSA严重性的调节。SWS可能与OSA患者表现出的心血管疾病高发风险有关。