目的:评估长期持续气道正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停(OSA)疾病严重程度的影响。
方法:我们分析了在广东省人民医院招募的参与者的睡眠呼吸暂停和心血管事件(SAVE)研究的结果,中国。参与者年龄为45-75岁,有心脑血管疾病史。OSA通过家庭睡眠呼吸暂停测试(HSAT)得到证实。参与者随机接受CPAP加标准心血管护理(CPAP组)或仅接受标准护理(UC组),并随访数年。在研究结论中,存活的参与者被邀请重复HSAT.通过独立样本t检验比较OSA指标的变化,并在按OSA严重程度分层的组中进行亚组分析。
结果:招募了一百零二名成年人(每组51人),随访48.0±14.5个月。CPAP组的每日CPAP使用率为4.1±1.9h。CPAP组和UC组的AHI从基线到研究结束均下降(-5.0(-12.5,2.0),P=0.000;-4.0(-12.5,1.5),分别为P=0.007),组间无差异(P=0.453)。在CPAP而非UC组中,从基线到研究结束,最低点SpO2改善(2.3%±6.1%,P=0.011和-0.7%±7.6%,分别为P=0.511;组间差异P=0.032)。亚组分析表明,CPAP可以改善中度OSA患者的AHI(CPAP组-8.0(-11.8,-2.8),-UC组2.0(-0.8,6.0),P=0.022)和改善CPAP组重度OSA患者的最低点SpO2(5.0(-0.8,-0.8,7.0),UC组0.0(-8.5,2.5),P=0.032)。
结论:长期使用CPAP并没有导致AHI或ODI总体上的临床显著变化,但显示出按OSA严重程度分层的可变效应。
背景:注册:临床试验,标题:持续气道正压治疗阻塞性睡眠呼吸暂停以预防心血管疾病(SAVE),URL:www.
结果:政府,标识符:NCT00738179。
To evaluate the effect of long-term continuous positive airway pressure (CPAP) treatment on disease severity of obstructive sleep apnea (OSA).
We analyzed results from the Sleep Apnea and Cardiovascular Events (SAVE) study involving participants recruited at the Guangdong Provincial People\'s Hospital,
China. Participants were aged 45-75 years with a history of cardiac or cerebrovascular disease. OSA was confirmed by home sleep apnea testing (HSAT). Participants were randomized to receive CPAP plus standard cardiovascular care (CPAP group) or standard care alone (UC group) and followed for several years. At the study conclusion, surviving participants were invited to repeat HSAT. Changes in OSA indicators were compared by independent samples t-tests and subgroup analysis was implied among groups stratified by OSA severity.
One hundred two adults were recruited (51 per group) and followed for 48.0 ± 14.5 months. Daily CPAP usage in the CPAP group was 4.1 ± 1.9 h.
AHI decreased from baseline to end-of-study in both CPAP and UC groups (- 5.0 (- 12.5,2.0), P = 0.000; - 4.0 (- 12.5,1.5), P = 0.007, respectively), with no between-group difference (P = 0.453). An improvement in nadir SpO2 showed from baseline to end-of-study in the CPAP but not UC group (2.3% ± 6.1%, P = 0.011 and - 0.7% ± 7.6%, P = 0.511, respectively; between-group difference P = 0.032). Subgroup analysis shows that CPAP could improve
AHI in patients with moderate OSA (- 8.0 (- 11.8, - 2.8) in CPAP group, - 2.0 (- 0.8,6.0) in UC group, P = 0.022) and improve nadir SpO2 in patients with severe OSA (5.0 (- 0.8, - 0.8,7.0) in CPAP group, 0.0 (- 8.5,2.5) in UC group, P = 0.032).
Long-term CPAP use did not result in clinically significant changes in
AHI or ODI overall but showed variable effects stratified by OSA severity.
Registry: Clinical Trials.gov, title: Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea to Prevent Cardiovascular Disease (SAVE), URL: www.
gov , identifier: NCT00738179.