Thorax:持续气道正压通气治疗对阻塞性睡眠呼吸暂停的心血管结局和临床表型的影响

2022-03-21 MedSci原创 MedSci原创

OSA相关的TST90和平均心率(但不是AHI)是MACE可靠的预测因子。研究人员确定了一个对持续气道正压通气治疗有益效果的临床亚组。

人们越来越意识到阻塞性睡眠呼吸暂停(OSA)患者存在异质性。探究持续气道正压通气治疗的心血管保护效应的临床试验结果大多为阴性。

近日,胸部疾病领域权威杂志Thorax上发表了一篇研究文章,研究人员旨在评估多导睡眠图参数与重大心血管不良事件(MACE)之间的关联,并探究是否可以更好地描述临床亚组之间的持续气道正压通气的效应。

这项睡眠队列研究是使用香港的临床数据库和全港电子健康管理数据进行的。研究人员采用Cox回归计算了风险比(HR)。潜在类别分析用于根据临床和多导睡眠图特征对OSA患者进行聚类分析。

在接受多导睡眠图检查的1860名符合条件的受试者中(2006-2013年),1544名(83%)患有OSA。在8.3年的中位随访中,278人(14.9%)经历了MACE。呼吸暂停-呼吸暂停指数(AHI)不能预测MACE(HR为0.95;95%CI为0.76至1.17),而氧饱和度<90%(TST90)的睡眠时间(HR为1.41;95%CI为1.10至1.81)是MACE的独立预测因子,清醒和夜间心率也是如此。在需要进行持续气道正压通气治疗的中重度OSA患者(n=1108)中,常规持续气道正压通气与MACE事件的减少无关。进一步的聚类分析确定了一个更年轻、更肥胖、更严重OSA(更高AHI和TST90)和更高心血管风险的亚组(n=333),其中定期持续气道正压通气与更低的MACE风险相关(HR为0.49,95%CI为0.25至0.95)。

由此可见,OSA相关的TST90和平均心率(但不是AHI)是MACE可靠的预测因子。研究人员确定了一个对持续气道正压通气治疗有益效果的临床亚组。

原始出处:

Pei-Hang Xu,et al.Cardiovascular outcomes in obstructive sleep apnoea and implications of clinical phenotyping on effect of CPAP treatment.Thorax.2022.https://thorax.bmj.com/content/early/2022/03/17/thoraxjnl-2021-217714

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    2022-06-26 tomyang96
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    2022-03-23 tastas
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    2022-03-23 12346c4dm64暂无昵称

    osa的治疗方式之一

    0

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