呼吸系统负担作为阻塞性睡眠呼吸暂停的衡量标准 严重程度是心血管和全因死亡率的预测
Ankit Parekh1, Korey Kam1, Sajila Wickramaratne1
1Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
American journal of respiratory and critical care medicine
|September 12, 2023
概括
一种新的测量方法 - - 呼吸器负担 (VB) - - 对诊断阻塞性睡眠呼吸暂停和预测死亡率有前途. 这种自动化工具可能会为传统的呼吸暂停-呼吸暂停指数 (AHI) 提供更好的替代方案.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统生理学 呼吸系统生理学
- 心血管流行病学心血管流行病学
背景情况:
- 呼吸暂停-呼吸暂停指数 (AHI) 在诊断阻塞性睡眠暂停 (OSA) 中是有限的,因为它只测量呼吸事件的频率.
- 现有的诊断工具可能无法完全捕捉OSA的严重程度或长期健康影响.
研究的目的:
- 引入和验证一个新的自动化测量,通风器负担 (VB),作为OSA评估的AHI的替代品.
- 评估VB预测所有原因和心血管疾病 (CVD) 死亡率的能力.
主要方法:
- 利用流行病学 (EPISONO,SHHS) 和临床 (DAYFUN) 队列的数据来得出规范性VB范围.
- 评估了上呼吸道阻塞严重程度和VB之间的关系.
- 检查了VB与所有原因和心血管疾病死亡率的关联,并对低氧负担和其他共变量进行调整.
主要成果:
- 在健康人群中确定了规范性VB范围 (第95个百分点:25.2%-26.7%).
- VB显示了与上呼吸道阻塞严重程度和较低的夜间变异性 (ICC=0.89) 的剂量反应关系.
- 在SHHS队列中,VB预测了全因和心血管疾病死亡率,在预测心血管疾病死亡率方面超过了AHI.
结论:
- 自动化呼吸器负担 (VB) 有效地评估OSA的严重程度并预测死亡率.
- 在OSA诊断和预后方面,VB显示出作为AHI的优质替代品的潜力.
- 这种新型指标可以通过更全面地评估睡眠呼吸障碍来改善患者的治疗结果.
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