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[持续气道正压通气疗法在睡眠呼吸暂停患者中的长期应用]

[Long term use of nCPAP therapy in sleep apnoea patients].

作者信息

Bizieux-Thaminy A, Gagnadoux F, Binquet C, Meslier N, Person C, Racineux J L

机构信息

Département de pneumologie, CHU, Angers.

出版信息

Rev Mal Respir. 2005 Dec;22(6 Pt 1):951-7. doi: 10.1019/200530095.

Abstract

INTRODUCTION

Although obstructive sleep apnoea syndrome (OSAS) is usually a lifelong condition, little is known about compliance with nasal continuous positive airway pressure (nCPAP) over longer periods of follow up.

METHODS

Long term acceptance of nCPAP was evaluated retrospectively using a survival analysis in 137 consecutive patients who started nCPAP therapy for OSAS between 1985 and 1993.

RESULTS

During a mean follow-up of 9.2 +/- 4.7 years, 30 patients died, 5 were lost of follow-up and 30 patients stopped their treatment most of them during the first 5 years. In compliant patients, the median value of daily nCPAP use was 7.5 hours. Kaplan Meier analysis showed that 82% of patients were still using nCPAP at 5 years, 77% at 10 years and 61% at 15 years. Multivariate analysis showed that OSAS severity was an independent predictor of long-term nCPAP use. The rate of nCPAP acceptance at 10 years was 82% in patients with an apnoea-hypopnoea index (AHI) > or = 30 compared to 58% in patients with AHI < 30.

CONCLUSION

nCPAP is a suitable long-term therapy for OSAS, particularly in patients with more severe disease, with more than 80% of patients continuing to be compliant with treatment at 10 years.

摘要

引言

尽管阻塞性睡眠呼吸暂停综合征(OSAS)通常是一种终身疾病,但对于长期随访中持续气道正压通气(nCPAP)的依从性了解甚少。

方法

对1985年至1993年间开始接受nCPAP治疗的137例OSAS患者进行回顾性生存分析,评估nCPAP的长期接受情况。

结果

平均随访9.2±4.7年期间,30例患者死亡,5例失访,30例患者停止治疗,其中大部分在最初5年内停止。在依从性患者中,每日使用nCPAP的中位数为7.5小时。Kaplan Meier分析显示,5年时82%的患者仍在使用nCPAP,10年时为77%,15年时为61%。多因素分析表明,OSAS严重程度是长期使用nCPAP的独立预测因素。呼吸暂停低通气指数(AHI)≥30的患者10年时nCPAP接受率为82%,而AHI<30的患者为58%。

结论

nCPAP是OSAS的一种合适的长期治疗方法,特别是对于病情较重的患者,10年时超过80%的患者仍持续依从治疗。

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