JAMA:居家通气设备对COPD伴高碳酸血症患者预后的影响

2020-02-05 MedSci MedSci原创

研究发现,对于伴有高碳酸血症的慢性阻塞性肺病患者,居家采用双水平气道正压通气可显著改善患者预后

近日,研究人员比较了双水平气道正压通气(BPAP)装置与无创家庭机械呼吸(HMV)装置对采用居家无创正压通气(NIPPV)治疗的慢性阻塞性肺病(COPD)患者临床结果和不良事件的影响。

本次研究为系统综述及荟萃分析,收集1995-2019年的相关资料,涉及患有高碳酸血症的慢性阻塞性肺病成年患者,患者使用NIPPV至少1个月。研究的主要终点为死亡、全因住院、插管和长期生活质量。

21个临床研究以及12个观察研究纳入本研究,总计包含51085名患者,平均年龄65.7岁,女性占43%,总计死亡434人,插管27人。相比于不采用任何设备,BPAP显著降低了死亡率(22.31% vs 28.57%,OR=0.66)、住院率(39.74% vs 75.00%,OR=0.22)和插管率(5.34% vs 14.71%,OR=0.34)。相比于不采用任何设备,HMV显著降低了住院率(OR=0.50),但对于死亡率无显著影响。通气设备对患者长期生活质量的影响不显著。

研究发现,对于伴有高碳酸血症的慢性阻塞性肺病患者,居家采用双水平气道正压通气可显著改善患者预后。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2086138, encodeId=43c52086138a9, content=<a href='/topic/show?id=a85f949005c' target=_blank style='color:#2F92EE;'>#通气设备#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94900, encryptionId=a85f949005c, topicName=通气设备)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Tue Jun 30 14:17:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692105, encodeId=b9b9169210535, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Mar 18 02:17:00 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585985, encodeId=fbf91585985b9, content=<a href='/topic/show?id=30e110253124' target=_blank style='color:#2F92EE;'>#高碳酸血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102531, encryptionId=30e110253124, topicName=高碳酸血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aff417344311, createdName=lvygwyt2787, createdTime=Fri Feb 07 01:17:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035892, encodeId=02a21035892c3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Feb 05 13:17:00 CST 2020, time=2020-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378923, encodeId=caff3e892303, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ww268miauWI6vzN1ibhl6jg0T4kYy9XuHVxCmmetAq550VLmjIicFWSq9oPfrgCIb2SBLe3fm4hSNhHRrpNGuYY0Q/132, createdBy=defb2406143, createdName=马松, createdTime=Wed Feb 05 11:15:02 CST 2020, time=2020-02-05, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2086138, encodeId=43c52086138a9, content=<a href='/topic/show?id=a85f949005c' target=_blank style='color:#2F92EE;'>#通气设备#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94900, encryptionId=a85f949005c, topicName=通气设备)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Tue Jun 30 14:17:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692105, encodeId=b9b9169210535, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Mar 18 02:17:00 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585985, encodeId=fbf91585985b9, content=<a href='/topic/show?id=30e110253124' target=_blank style='color:#2F92EE;'>#高碳酸血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102531, encryptionId=30e110253124, topicName=高碳酸血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aff417344311, createdName=lvygwyt2787, createdTime=Fri Feb 07 01:17:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035892, encodeId=02a21035892c3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Feb 05 13:17:00 CST 2020, time=2020-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378923, encodeId=caff3e892303, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ww268miauWI6vzN1ibhl6jg0T4kYy9XuHVxCmmetAq550VLmjIicFWSq9oPfrgCIb2SBLe3fm4hSNhHRrpNGuYY0Q/132, createdBy=defb2406143, createdName=马松, createdTime=Wed Feb 05 11:15:02 CST 2020, time=2020-02-05, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2086138, encodeId=43c52086138a9, content=<a href='/topic/show?id=a85f949005c' target=_blank style='color:#2F92EE;'>#通气设备#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94900, encryptionId=a85f949005c, topicName=通气设备)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Tue Jun 30 14:17:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692105, encodeId=b9b9169210535, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Mar 18 02:17:00 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585985, encodeId=fbf91585985b9, content=<a href='/topic/show?id=30e110253124' target=_blank style='color:#2F92EE;'>#高碳酸血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102531, encryptionId=30e110253124, topicName=高碳酸血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aff417344311, createdName=lvygwyt2787, createdTime=Fri Feb 07 01:17:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035892, encodeId=02a21035892c3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Feb 05 13:17:00 CST 2020, time=2020-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378923, encodeId=caff3e892303, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ww268miauWI6vzN1ibhl6jg0T4kYy9XuHVxCmmetAq550VLmjIicFWSq9oPfrgCIb2SBLe3fm4hSNhHRrpNGuYY0Q/132, createdBy=defb2406143, createdName=马松, createdTime=Wed Feb 05 11:15:02 CST 2020, time=2020-02-05, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2086138, encodeId=43c52086138a9, content=<a href='/topic/show?id=a85f949005c' target=_blank style='color:#2F92EE;'>#通气设备#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94900, encryptionId=a85f949005c, topicName=通气设备)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Tue Jun 30 14:17:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692105, encodeId=b9b9169210535, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Mar 18 02:17:00 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585985, encodeId=fbf91585985b9, content=<a href='/topic/show?id=30e110253124' target=_blank style='color:#2F92EE;'>#高碳酸血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102531, encryptionId=30e110253124, topicName=高碳酸血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aff417344311, createdName=lvygwyt2787, createdTime=Fri Feb 07 01:17:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035892, encodeId=02a21035892c3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Feb 05 13:17:00 CST 2020, time=2020-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378923, encodeId=caff3e892303, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ww268miauWI6vzN1ibhl6jg0T4kYy9XuHVxCmmetAq550VLmjIicFWSq9oPfrgCIb2SBLe3fm4hSNhHRrpNGuYY0Q/132, createdBy=defb2406143, createdName=马松, createdTime=Wed Feb 05 11:15:02 CST 2020, time=2020-02-05, status=1, ipAttribution=)]
    2020-02-05 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2086138, encodeId=43c52086138a9, content=<a href='/topic/show?id=a85f949005c' target=_blank style='color:#2F92EE;'>#通气设备#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94900, encryptionId=a85f949005c, topicName=通气设备)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Tue Jun 30 14:17:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692105, encodeId=b9b9169210535, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Mar 18 02:17:00 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1585985, encodeId=fbf91585985b9, content=<a href='/topic/show?id=30e110253124' target=_blank style='color:#2F92EE;'>#高碳酸血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102531, encryptionId=30e110253124, topicName=高碳酸血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aff417344311, createdName=lvygwyt2787, createdTime=Fri Feb 07 01:17:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035892, encodeId=02a21035892c3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Feb 05 13:17:00 CST 2020, time=2020-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378923, encodeId=caff3e892303, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ww268miauWI6vzN1ibhl6jg0T4kYy9XuHVxCmmetAq550VLmjIicFWSq9oPfrgCIb2SBLe3fm4hSNhHRrpNGuYY0Q/132, createdBy=defb2406143, createdName=马松, createdTime=Wed Feb 05 11:15:02 CST 2020, time=2020-02-05, status=1, ipAttribution=)]
    2020-02-05 马松

    学习

    0

相关资讯

2025年COPD市场有望突破140亿美元 4款药物“搅局”

慢性阻塞性肺疾病(COPD)是导致全球超过2.5亿人发生呼吸困难的一种疾病,据估计,COPD相关的肺气肿和慢性支气管炎每年导致约300万人死亡。在美国,近1600万人受到COPD的影响,该疾病也是美国第三大致死因素。

Eur Respir J:COPD患者吸入皮质类固醇与肺癌发病率

由此可见,吸入皮质类固醇激素与减少COPD患者的肺癌发生率无关。观察性研究报道,这种减少可能受到与时间相关的偏倚和纳入哮喘患者的影响。

Eur Respir J:中国成年人肥胖指标与COPD风险之间的关联

由此可见,腹部肥胖和体重过轻是中国成人COPD的危险因素。预防COPD时应同时考虑BMI和腹部肥胖。

NEJM:美托洛尔预防COPD急性加重(BLOCK COPD试验)?

β受体阻滞剂对 COPD 患者的影响,一直存在争议。理论上β受体阻滞剂对 COPD 患者可能产生不利影响,但实际临床研究却给出了相反的结论。 一项纳入了 2230 例患者的研究结果显示,对于使用选择性β受体阻滞剂的 COPD 患者,β受体阻滞剂不但不会导致 COPD 症状恶化,反而具有减少 COPD 急性发作风险,同时能够显著提高 COPD 患者生存状况; 多项 meta 分析和系

NEJM:美托洛尔预防COPD急性加重的疗效分析

由此可见,在中度或重度COPD患者中,尚未确定使用β-受体阻滞剂的指征,美托洛尔组和安慰剂组出现首次COPD恶化的时间相似。在接受美托洛尔治疗的患者中,因加重而住院治疗更为常见。

Chest:COPD患者的心血管风险

由此可见,对未选择的原因不同的COPD患者分析表明:1)COPD本身不足以解释其增加aPWV,2)吸烟是COPD患者aPWV增加的危险因素。