持续的正气道压力和下前进:CHOICE多中心,开放式随机临床试验
Mona M Hamoda1, Nelly Huynh2, Najib T Ayas3
1Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada falmeida@dentistry.ubc.ca.
The European respiratory journal
|December 5, 2024
概括
在阻塞性睡眠呼吸暂停 (OSA) 中,下推进 (MAS) 显示出比持续正气道压力 (CPAP) 更好的粘附性. 这两种疗法都改善了患者的治疗结果,这表明将MAS和CPAP结合起来可以改善长期的OSA管理.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 生物医学工程 生物医学工程
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 管理面临的挑战是对持续正气道压力 (CPAP) 的低坚持.
- 替代疗法对于改善OSA患者的治疗坚持和治疗结果至关重要.
- 这项研究旨在将CPAP与下前进 (MAS) 进行OSA管理.
研究的目的:
- 在OSA患者中比较CPAP和MAS之间的客观坚持率.
- 评估CPAP和MAS作为独立和联合疗法的有效性.
- 为了确定患者治疗使用模式,并评估临床有效性.
主要方法:
- 进行了一项多中心,双随机,三阶段的试验.
- 患有轻度至重度OSA的参与者经历了定位,交叉和观察阶段.
- 目标坚持 (小时/夜) 和疗效是交叉阶段的主要结果.
主要成果:
- 与CPAP (每晚5.3小时) 相比,下推进支线 (MAS) 的坚持率显著更高 (每晚6.0小时).
- 两种疗法在以患者为中心的结局上表现出相似的临床有效性,尽管在坚持和疗效方面存在差异.
- 55%的参与者选择在观察阶段在CPAP和MAS之间交替使用.
结论:
- 虽然CPAP更有效,但MAS为OSA治疗提供了更高的坚持.
- 无论是CPAP还是MAS,都在以患者为中心的结果方面提供了可比的临床有效性.
- 使用CPAP和MAS可以提高阻塞性睡眠呼吸暂停的长期管理.
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