在中风后患有睡眠呼吸障碍的患者中CPAP疗法的效果:系统性审查和元分析
European neurology
|March 6, 2026
概括
持续的阳性气道压力 (CPAP) 治疗可能会降低中风和死亡率在中风或过渡性缺血性攻击 (TIA) 后睡眠呼吸障碍 (SDB) 患者的复发性中风. 结果取决于遵守CPAP治疗.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
背景情况:
- 睡眠呼吸障碍 (SDB),特别是阻塞性睡眠呼吸暂停 (OSA),在中风后很普遍,并且与不良结果有关.
- 持续正气道压力 (CPAP) 是一种潜在的干预措施,但它对中风幸存者的有效性尚不清楚.
研究的目的:
- 系统地评估CPAP治疗在中风或SDB的过渡性缺血性发作 (TIA) 后的成年人中的疗效.
主要方法:
- 随机对照试验 (RCT) 和观察性研究的系统审查和元分析.
- 搜索了MEDLINE,Embase和Cochrane CENTRAL的CPAP与对照组进行比较的研究.
- 分析了复发性中风/TIA和全因死亡率的初级结果,以及包括功能和认知状态在内的二级结果.
主要成果:
- CPAP治疗显著降低了复发性中风的几率 (OR 0.49).
- 观察数据表明,CPAP降低了全因死亡率 (OR 0.50),尽管RCT没有显示短期影响.
- 高CPAP坚持与更好的功能和认知结果以及减少嗜睡相关.
结论:
- 在中风后的SDB患者中,CPAP疗法在减少中风复发和潜在的全因死亡率方面表现有前途.
- 功能和认知方面的好处是不一致的,并且与患者坚持CPAP治疗有很强的关联.
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