阻塞性睡眠呼吸暂停中的面表型及其对正气道压力 (PAP) 坚持的影响
Jae-Seon Park1, Bin Kwon2, Hyun-Seok Kang1
1Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea.
Journal of personalized medicine
|August 25, 2023
概括
阻塞性睡眠呼吸暂停 (OSA) 患者的阳性气道压力 (PAP) 坚持与特定的脑力计测量有关. 位于较低位置的舌骨,由较长的H-MP和H-PNS测量结果表明,与更好的PAP粘附性和增加的OSA严重性有关.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 医疗成像医学成像
背景情况:
- 阳性气道压力 (PAP) 对于治疗中度至重度阻塞性睡眠呼吸暂停 (OSA) 至关重要,其坚持会显著影响结果.
- 虽然疾病严重程度和不良影响等因素影响了粘附性,但脑测量参数在预测PAP粘附性方面的作用尚未得到充分研究.
- 脑力测量参数反映了上呼吸道解剖学,可以提供关于OSA患者PAP坚持的见解.
研究的目的:
- 调查阻塞性睡眠呼吸暂停患者在特定的脑表参数和PAP坚持之间的相关性.
- 使用计算机断层扫描 (CT) 图像识别PAP粘附的解剖学预测因素.
- 为了确定头脑测量测量是否可以预测治疗坚持和OSA严重程度.
主要方法:
- 包括一个由185名通过多睡眠学 (PSG) 诊断出OSA并处方PAP的患者组成的队列.
- 鼻腔计算机断层扫描 (PNS CT) 用于测量脑力测量参数,包括尾后鼻脊 (H-PNS) 和尾下平面 (H-MP).
- 药物处方后3-12个月评估了PAP的坚持,并进行了统计分析 (ANCOVA,逻辑回归) 来评估相关性.
主要成果:
- 在185名患者中,有136人坚持PAP. 坚持的群体有更多的男性和更高的平均身高.
- 具有更好的PAP坚持度的患者表现出明显更高的呼吸障碍指数 (RDI),氧气不和指数 (ODI) 和兴奋指数 (AI).
- 较长的H-MP (p=0.027) 和较长H-PNS的趋势 (p=0.074) 在调整性别和身高后与PAP坚持有显著的关联. 较高的H-MP和H-PNS三位数与依附率增加和严重的OSA相关.
结论:
- 在较长的H-MP和H-PNS测量结果中显示的下位的舌骨与成人OSA患者的更好的PAP坚持有关.
- 这些脑力测量参数可以作为预测PAP坚持和评估OSA疾病严重程度的有价值指标.
- 对OSA和PAP坚持的解剖基础的进一步研究可以改进治疗策略.
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