CHEST:急性心源性肺水肿的又一重要致死因素!

2017-08-26 MedSci MedSci原创

急性心源性肺水肿(ACPE)是一种危及生命的疾病。阻塞性睡眠呼吸暂停(OSA)可能是ACPE复发的一种可改变的危险因素。近期,一项发表在杂志CHEST上的研究旨在评估OSA对ACPE恢复后心血管事件发生率的影响。此项研究选择了3个中心连续确诊的ACPE患者,在临床稳定后进行睡眠研究。OSA被定义为呼吸暂停-低通气指数(AHI)≥15事件/小时。平均随访1年,此项研究的主要结果是ACPE复发。此项研

急性心源性肺水肿(ACPE)是一种危及生命的疾病。阻塞性睡眠呼吸暂停(OSA)可能是ACPE复发的一种可改变的危险因素。


近期,一项发表在杂志CHEST上的研究旨在评估OSA对ACPE恢复后心血管事件发生率的影响。

此项研究选择了3个中心连续确诊的ACPE患者,在临床稳定后进行睡眠研究。OSA被定义为呼吸暂停-低通气指数(AHI)≥15事件/小时。平均随访1年,此项研究的主要结果是ACPE复发。

此项研究结果最终共纳入104例患者,其中61%的患者有OSA。与无OSA患者相比,在OSA患者中观察到ACPE的复发率(25 vs. 6次发作,p = 0.01)和心肌梗死发生率较高(15 VS. 0次发作,p = 0.0004)。所有17例死亡均发生在OSA组(p = 0.0001)。

在Cox比例模型中,OSA与ACPE复发(HR 3.3;95%CI 1.2-8.8;p = 0.01),心肌梗死发生率(HR 2.3;95%CI 1.1-9.5;p = 0.02),心血管死亡(HR 5.4;95%CI 1.4-48.4;p = 0.004)和总死亡(HR 6.5;95%CI 1.2-64.0;p = 0.005)独立相关。

当仅分析OSA患者时,出现ACPE复发或死亡的患者的AHI和低氧负荷水平以及睡眠发作ACPE的发生率显着高于未经历这些事件的患者。

此项研究表明,OSA与更高的ACPE复发率以及致命的和非致命的心血管事件独立相关。

原始出处:
Uchôa CHG, Pedrosa RP, et al. Obstructive Sleep Apnea and Prognosis after Acute Cardiogenic Pulmonary Edema: The OSA-CARE study. Chest. 2017 Aug 16. pii: S0012-3692(17)31396-X. doi: 10.1016/j.chest.2017.08.003. 

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    2018-02-04 Smile2680
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    2017-08-28 小华子
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    2017-08-28 mhm295
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    2017-08-26 Y—xianghai

    学习了新知识

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1929404, encodeId=75e1192940433, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sun Feb 04 03:12:00 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050824, encodeId=85e12050824f3, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue May 01 22:12:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333375, encodeId=95b113333e54a, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Mon Aug 28 03:12:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593447, encodeId=bf8c159344e81, content=<a href='/topic/show?id=9850510e9a3' target=_blank style='color:#2F92EE;'>#心源性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51079, encryptionId=9850510e9a3, topicName=心源性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=955718147815, createdName=mhm295, createdTime=Mon Aug 28 03:12:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237402, encodeId=95a023e40239, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sat Aug 26 15:25:10 CST 2017, time=2017-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237381, encodeId=1f5f23e381a5, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sat Aug 26 13:08:44 CST 2017, time=2017-08-26, status=1, ipAttribution=)]
    2017-08-26 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0