背景:阻塞性睡眠呼吸暂停(OSA)是一种长期疾病,其特征是睡眠期间上呼吸道频繁阻塞,经常导致突然的觉醒,有或没有氧气水平的降低。系统评价和荟萃分析旨在评估持续气道正压通气治疗(CPAP)对血白细胞介素(IL)水平、IL-6、IL-10、IL-18、IL-1β、OSA成人中的IL-4和IL-17。
方法:PubMed发布的数据库,Scopus,WebofScience,和Cochrane图书馆从2003年到2024年进行了搜索,没有任何限制。ReviewManager软件5.3用于计算效果大小,以标准化平均差(SMD)和95%置信区间(CI)表示。
结果:总计,通过数据库搜索确定了320条记录;最终,42篇文章被纳入定性综合,然后进行荟萃分析。CPAP治疗显著降低IL-6水平,如SMD=0.64[95%CI:0.35,0.93]和P<0.0001。CPAP治疗显著降低成人OSA患者的IL-18和IL-1β水平,但IL-10,IL-4或IL-17水平没有显着差异。年龄,血液样本,身体质量指数,种族,IL-6的治疗持续时间和具有IL-10水平的呼吸暂停低通气指数是合并结果的有效因素。实验上,IL-18和IL-1β之间存在相互作用。
结论:CPAP治疗对成人OSA的炎症标志物有积极影响;它降低IL-6和IL-1β水平。然而,需要更多的证据(如种族的作用)和对相互作用的理解。
BACKGROUND: Obstructive sleep apnoea (OSA) is a long-term disorder characterized by frequent blockages in the upper respiratory tract during sleep, often leading to abrupt awakenings, with or without a decrease in oxygen levels. The systematic review and meta-analysis aimed to assess the effect of continuous positive airway pressure therapy (CPAP) on blood interleukin (IL) levels of IL-6, IL-10, IL-18, IL-1β, IL-4, and IL-17 in OSA adults.
METHODS: The published databases from PubMed, Scopus, Web of Science, and Cochrane Library were searched from 2003 to 2024, without any restrictions. The Review Manager software 5.3 was employed to compute effect sizes, which were presented as the standardized mean difference (SMD) along with a 95% confidence interval (CI).
RESULTS: In total, 320 records were identified through database searching; ultimately, 42 articles were included in the qualitative synthesis and then the meta-analysis. The CPAP therapy significantly reduces IL-6 levels, as indicated SMD=0.64 [95% CI: 0.35, 0.93] and P<0.0001. CPAP therapy significantly reduced IL-18 and IL-1β levels in adults with OSA, but there is no significant difference in IL-10, IL-4, or IL-17 levels. Age, blood sample, body mass index, ethnicity, and treatment duration for IL-6 and apnoea-hypopnea index with IL-10 levels were effective factors in the pooled results. Experimentally, there was an interaction between IL-18 and IL-1β.
CONCLUSIONS: CPAP therapy has a positive impact on inflammatory markers in OSA adults; remarkably, it reduces IL-6 and IL-1β levels. Nevertheless, more evidence (such as the role of ethnicity) and understanding of interactions are needed.