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[夜间氧疗对慢性阻塞性肺疾病合并单纯睡眠相关性低氧血症患者生活质量的影响:一项前瞻性、安慰剂对照交叉试验]

[Influence of nocturnal oxygen therapy on quality of life in patients with COPD and isolated sleep-related hypoxemia: a prospective, placebo-controlled cross-over trial].

作者信息

Orth M, Walther J W, Yalzin S, Bauer T T, de Zeeuw J, Kotterba S, Baberg H T, Schultze-Werninghaus G, Rasche K, Duchna H-W

机构信息

Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Bochum.

出版信息

Pneumologie. 2008 Jan;62(1):11-6. doi: 10.1055/s-2007-980129. Epub 2007 Nov 15.

Abstract

BACKGROUND

In patients with COPD and isolated night time hypoxemia, oxygen administration has not shown any effects on life expectancy and the development of pulmonal arterial hypertension. The aim of the present pilot study was to investigate the influence of nocturnal oxygen therapy on the quality of life in daytime normoxemic COPD patients with nocturnal oxygen desaturations.

PATIENTS AND METHODS

19 patients with COPD, in a stable phase of the disease without need for oxygen supplementation under rest (PaO2 62.7 +/- 4.9 mmHg) and nocturnal hypoxemia (t90 = 55.5 +/- 33.4 % of registration time, mean SaO2 89.8 +/- 1.9 %, minimal SaO2 81.1 +/- 4.8 %) were randomly assigned to either oxygen or placebo treatment, both generated by identical concentrator devices. Each treatment period lasted 6 weeks, after six weeks a cross-over was performed by a technician. Quality of life was assessed before and at the end of each treatment period by the SF-36, Nottingham Health Profile and Saint George's Respiratory Questionnaire.

RESULTS

Significant differences for the comparison of placebo and verum were only seen for the dimension sleep (NHP), all other dimensions showed no differences between placebo and oxygen. However, both placebo and oxygen improved the majority of the quality of life items significantly.

CONCLUSIONS

The prescription of supplemental oxygen in COPD patients with isolated nocturnal hypoxemia in the present pilot study is not able to improve the quality of life within 6 weeks after initiation of therapy. It cannot, therefore, be generally recommended, but may be indicated in patients with a documented improvement of sleep quality.

摘要

背景

在慢性阻塞性肺疾病(COPD)合并单纯夜间低氧血症的患者中,氧疗对预期寿命和肺动脉高压的发展未显示出任何影响。本初步研究的目的是探讨夜间氧疗对白天血氧正常但存在夜间氧饱和度下降的COPD患者生活质量的影响。

患者与方法

19例处于疾病稳定期、静息时无需吸氧(动脉血氧分压[PaO2]为62.7±4.9 mmHg)且存在夜间低氧血症(t90为记录时间的55.5±33.4%,平均动脉血氧饱和度[SaO2]为89.8±1.9%,最低SaO2为81.1±4.8%)的COPD患者被随机分为氧疗组或安慰剂治疗组,两种治疗均由相同的制氧设备产生。每个治疗期持续6周,6周后由一名技术人员进行交叉治疗。在每个治疗期开始前和结束时,通过简明健康状况调查问卷(SF-36)、诺丁汉健康量表和圣乔治呼吸问卷评估生活质量。

结果

仅在睡眠维度(诺丁汉健康量表)上,安慰剂组和治疗组之间存在显著差异,其他所有维度在安慰剂组和氧疗组之间均无差异。然而,安慰剂组和氧疗组均显著改善了大多数生活质量项目。

结论

在本初步研究中,对于单纯夜间低氧血症的COPD患者,补充氧气治疗在开始治疗后的6周内无法改善生活质量。因此,一般不推荐使用,但对于睡眠质量有记录改善的患者可能适用。

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