通过静脉的神经刺激治疗中心睡眠呼吸暂停:随机对照试验
Maria Rosa Costanzo1, Piotr Ponikowski2, Shahrokh Javaheri3
1Advocate Heart Institute, Naperville, IL, USA.
Lancet (London, England)
|September 7, 2016
概括
通过静脉的神经刺激显著改善了中心睡眠呼吸暂停 (CSA),在51%的患者中减少了50%以上的呼吸暂停- 呼吸暂停指数 (AHI). 这种可植入的装置提供了安全有效的CSA治疗方法.
科学领域:
- 医疗器械
- 神经学
- 肺病学
背景情况:
- 中心睡眠呼吸暂停 (CSA) 是一种严重的疾病,与不良健康结果有关.
- 雷梅德系统是一种可植入的装置,旨在通过静脉神经刺激治疗CSA.
- 本研究评估了单边神经刺激对CSA患者的安全性和有效性.
研究的目的:
- 评估治疗中心睡眠呼吸暂停的安全性和有效性.
- 将接受神经刺激的患者与对照组的呼吸暂停- 呼吸暂停指数 (AHI) 的降低进行比较.
- 在12个月内评估与植入器件和治疗相关的严重不良事件.
主要方法:
- 这是一项前性多中心随机试验,涉及151名中度至重度CSA患者.
- 患者被随机分配 (1:1) 接受通过静脉的神经刺激或没有刺激6个月.
- 主要终点是通过多睡眠学评估的AHI降低≥50%.
主要成果:
- 与对照组相比,治疗组中显著更多的患者 (51%) 实现了≥50%的AHI降低 (11%) (p< 0. 0001).
- 在12个月内,与该系统或治疗相关的严重不良事件的总比率很低 (治疗组为8%,对照组为9%).
- 在治疗组中,有37%的人报告了不严重的不适,其中大多数通过重新编程而消失.
结论:
- 使用remedé系统进行的静脉神经刺激有效降低了CSA的严重程度.
- 该疗法在睡眠指标,氧化和生活质量方面显示出临床上有意义的改善.
- 通过静脉的神经刺激为患有中心睡眠呼吸暂停的患者提供了一个有前途的治疗方案.
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