COPDとOSAの重複症候群の世界的な流行:体系的なレビューとメタ解析
Huiru Li1, Jiang Yang1, Qionghua Xiao1
1National Regional TCM (lung disease) Diagnostic and Treatment Center, The First Affiliated Hospital of Henan University of TCM, Zhengzhou, China; First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China.
Sleep medicine
|August 30, 2025
まとめ
患者の約3分の1はCOPDとOSAの重複症候群であり,この状態は時間とともに悪化する. 定期的なスクリーニングと介入は,この一般的な呼吸器疾患の管理に不可欠です.
科学分野:
- 肺科
- 睡眠医学
- 流行病学
背景:
- COPDとOSAの重複症候群は,呼吸器の症状の増加,生活の質の低下,および悪化のリスクの上昇と関連している一般的な状態です.
- COPDとOSAの重複症候群の既存の流行率は著しく異なっており,世界的なコンセンサスが欠けている.
- このレビューは,COPDとOSAの重複症候群の世界的な流行に関する包括的な概要を提供します.
研究 の 目的:
- COPDとOSAの重複症候群の世界的な流行を体系的に検討し,メタ分析する.
- 研究における流行率の推定における異質性に貢献する要因を特定する.
主な方法:
- 2025年2月24日まで,Embase,PubMed,Web of Science,Cochrane,Ovid Medlineで体系的な文献検索が行われました.
- ランダム効果のメタ解析はRソフトウェアを使用して行われ,異質性はI2指数を使用して評価された.
- センシビリティ,サブグループ,メタ・リグレッション分析を用いて異質性の源を探求し,Beggテストを用いて出版バイアスを評価した.
主要な成果:
- この分析には1, 871, 071人の参加者を含む41件の研究が含まれており,COPDとOSAの重複症候群の全般的な流行率は28. 3% (95%CI: 20. 8~36. 4%) であった.
- 横断的な研究 (30. 66%) とアジア (37. 87%) で高かった.
- 家庭での睡眠時無呼吸検査 (HSAT) とポリソムノグラフィ (PSG) の間では,罹患率の推定値は比較可能であり,無呼吸時無呼吸指数 (AHI) の値が≥5と比べて高い. 研究期間,人口,サンプルサイズ,年齢が流行に影響した.
結論:
- 約3分の1の患者はCOPDとOSAの重複症候群を示し,その罹患率は時間とともに増加しています.
- 人口,時間,サンプルサイズ,年齢によって有意な疫学的な差異がある.
- 定期的なCOPDまたはOSAのスクリーニングと効果的な管理戦略の実施は,健康への悪影響を軽減するために推奨されます.
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