睡眠呼吸暂停在间歇性肺部疾病:一个系统的审查和流行,严重程度和风险因素的元分析
Jia-Wei Sun1, Hsiang-Chih Hsu1, Jie-Syuan Wu1
1School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Sleep medicine
|September 21, 2025
概括
阻塞性睡眠呼吸暂停 (OSA) 影响68%的间歇性肺病 (ILD) 患者,IPF的发病率更高. 对于肺功能减弱或BMI较高的男性,建议进行例行查,以改善结果.
科学领域:
- 肺部医学 肺部医学
- 睡眠医学 睡眠医学
- 呼吸系统研究 呼吸系统研究
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是患有间歇性肺病 (ILD) 的患者中普遍存在的并发症.
- 在ILD人群中,OSA显著影响疾病进展和患者的结果.
- 了解在ILD中OSA的患病率和风险因素对于有效管理至关重要.
研究的目的:
- 估计在被诊断为ILD的患者中OSA的总体患病率.
- 为了确定OSA的患病率,特别是在异常性肺纤维化 (IPF) 和其他ILD亚型中.
- 调查OSA与关键肺功能参数以及患者风险因素之间的关联.
主要方法:
- 进行了全面的元分析,搜索了PubMed,Embase和Cochrane图书馆的相关研究.
- 包括2025年2月之前发表的评估ILD患者OSA患病率或呼吸暂停-呼吸暂停指数 (AHI) 的研究.
- 主要结局包括OSA患病率和严重程度 (AHI);次要结局检查了与FVC,DLCO,6MWD,BMI,吸烟和性别的关联.
主要成果:
- 分析包括17项研究,包括1092名参与者,显示ILD患者的整体OSA患病率为68%.
- 与非IPFILD患者相比,IPF患者的OSA患病率 (71%) 较高.
- OSA患病率与较低的FVC,男性性别和较高的BMI有关;AHI与6MWD和BMI有轻微的关联. 在FVC<80%,6MWD<372m,BMI>31kg/m2的患者中,发现OSA风险增加.
结论:
- 由于OSA的高患病率 (68%) 需要在ILD患者中进行常规查.
- 对于预测FVC<80%,BMI>31 kg/m2或6MWD<372m的男性,应优先进行查.
- 在ILD患者的早期OSA检测和干预可能会改善临床结果.
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