床头升高对药物诱导睡眠内镜期间上呼吸道缩性的影响
Grant S Owen1, Vidit M Talati2, Yanyu Zhang3
1Rush Medical College, Rush University Medical Center, Chicago, Illinois.
概括
在阻塞性睡眠呼吸暂停患者的药物诱导睡眠内镜 (DISE) 期间,床头升高显著降低了上呼吸道缩性. 这一发现为定位治疗和替代治疗选择提供了新的见解.
科学领域:
- 睡眠医学 睡眠医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 药物诱导睡眠内镜 (DISE) 带有正气道压力 (PAP) 对于评估阻塞性睡眠呼吸暂停 (OSA) 中的上呼吸道缩性至关重要.
- 身体位置,特别是床头高度 (HOB) 对DISE评估的影响在很大程度上仍然没有特征.
- 了解位置效应对于优化OSA患者的诊断准确性和治疗策略至关重要.
研究的目的:
- 为了调查床头的升高是否会影响在药物诱导睡眠内镜期间对上呼吸道缩性的评估.
- 为了确定30°的床头升高是否会改变呼吸道的折叠性,与OSA患者的水平位置相比.
主要方法:
- 一项前性队列研究,涉及61名患有OSA不耐持续正气道压力 (CPAP) 治疗的成年患者.
- 患者接受了药物诱导睡眠内镜 (DISE) 在卧卧的两种位置:床头水平和升至30°.
- 在所有四个地点使用标准化的VOTE评分和气道打开压力来评估气道缩性.
主要成果:
- 该研究主要包括中年,肥胖的男性,患有中度至重度的位置性阻塞性睡眠呼吸暂停症.
- 在所有四个HOB升高的上呼吸道部位 (P < .01) 观察到气道开口压力的显著下降.
- 在平面和30°升高的位置之间,没有发现VOTE得分的显著差异.
结论:
- 将床头升至30°显著降低了DISE的OSA患者的上呼吸道缩性.
- 尽管可折叠性减少,但VOTE评分没有显著变化,这表明在位置变化下,这个评分系统的潜在局限性.
- 研究结果可能有助于开发定位疗法和OSA的替代治疗策略.
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