慢性阻塞性肺病患者的长期死亡率,需要急性非侵入性通风,有或没有阻塞性睡眠呼吸暂停
Benjamin Hm Nguyen1,2,3,4, Collette Menadue2, Brendon J Yee2,3,4
1St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia benjamin.nguyen@svha.org.au.
患有慢性阻塞性肺病和需要通风的阻塞性睡眠呼吸暂停重叠综合征 (OVS) 的患者的死亡率低于单独的COPD. 早期诊断和治疗COPD患者的OSA在急性呼吸衰竭患者的急性呼吸衰竭可能会改善生存率.
科学领域:
- 肺部医学 肺部医学
- 睡眠医学 睡眠医学
- 关键的护理关键的护理
背景情况:
- 慢性阻塞性肺病 (COPD) 患者的阻塞性睡眠呼吸暂停 (OSA) 被称为重叠综合征 (OVS).
- 与单独的COPD相比,OVS与稳定的门诊患者的死亡率增加有关.
- 住院的OVS患者经历急性超气呼吸衰竭 (ARF) 的预后仍然不清楚.
研究的目的:
- 与单独的COPD相比,研究OVS患者的预后和生存率.
- 评估积极气道压力 (PAP) 治疗对ARF的OVS患者死亡率的影响.
主要方法:
- 追溯队列研究包括124名COPD和44名OVS患者,他们接受了ARF的PAP治疗.
- 排除在急诊/重症监护病房治疗的患者,在病房内没有持续PAP.
- 患者特征和整体存活时间的比较,随访时间中位数为20.6个月.
主要成果:
- 在OVS患者中,高血压和2型糖尿病的发病率较高.
- 单变量分析表明OVS的死亡率低于单独的COPD (HR 0.57).
- 与未接受治疗 (36.1个月) 和COPD患者相比,在家庭PAP治疗 (59.0个月) 后出院的OVS患者的中位生存时间显著更高.
结论:
- 患有ARF的住院COPD患者可能面临比OVS患者更高的死亡率.
- 在出院后对OVS患者进行家庭PAP治疗的启动与死亡率降低有关.
- 建议在患有ARF的COPD患者早期诊断OSA并启动长期PAP治疗.
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