成年人的阻塞性睡眠呼吸暂停查:美国预防服务工作组的最新证据报告和系统审查
Cynthia Feltner1,2,3, Ina F Wallace1,4, Shannon Aymes2
1RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center.
JAMA
|November 15, 2022
概括
在成年人中进行阻塞性睡眠呼吸暂停 (OSA) 查的准确性和临床实用性不确定. 像正气压这样的治疗方法可以改善睡眠和生活质量,但不能显著降低死亡率或重大健康事件.
科学领域:
- 睡眠医学
- 预防健康
- 临床诊断
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与严重的不良健康结果有关.
- 需要有效的查策略进行早期检测和干预.
研究的目的:
- 评估无症状或未诊断成人的查测试准确性的证据.
- 根据美国预防服务工作组的建议.
主要方法:
- 对查测试准确性研究,随机临床试验 (RCT) 和元分析进行系统审查.
- 搜索了主要的数据库 (PubMed,Embase,Cochrane) 和试验注册表.
- 包括报告测试准确性,生活质量和健康结果的研究.
主要成果:
- 查的准确性有所不同;多变异性呼吸暂停预测得分显示严重的睡眠暂停的准确性很好 (AUC为0. 80- 0. 83).
- 阳性气道压力 (PAP) 和下推进装置改善了过度白天睡眠 (ESS) 和生活质量 (QOL).
- 没有发现PAP治疗显著降低死亡率,心血管事件或车祸;观察到适度的血压降低.
结论:
- 初级保健OSA查工具的临床效用和准确性仍然不确定.
- 虽然PAP和下前进装置改善症状和QOL,但它们对主要健康结果的长期影响需要进一步调查.
- 证据不支持查降低死亡率或重大不良健康事件.
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