杜氏肌营养不良症中的睡眠呼吸障碍：文献评估
Sleep-Disordered Breathing in Duchenne Muscular Dystrophy: An Assessment of the Literature.
作者信息
Hoque Romy
机构信息
Emory Sleep Center, Department of Neurology, Emory University School of Medicine, Atlanta, GA.
出版信息
J Clin Sleep Med. 2016 Jun 15;12(6):905-11. doi: 10.5664/jcsm.5898.
STUDY OBJECTIVES
The aim of this review is to review the literature on sleep-disordered breathing in Duchenne muscular dystrophy (DMD).
METHODS
PubMed was searched with an array of search terms, including "OSA," "obstructive sleep apnea," "sleep-disordered breathing," "muscular dystrophy," "neuromuscular," "Duchenne muscular dystrophy," "polysomnography," and "portable monitoring." All relevant articles were discussed.
RESULTS
Eighteen research articles and 1 consensus statement were reviewed, and assessed with relevant data presented. Three early studies prior to 1990 assessed DMD associated obstructive sleep apnea. Five studies assessed positive airway pressure (PAP) ventilation and/or sleep in varying neuromuscular disorders, including a cohort with DMD. Six studies since 2000 include PSG data in exclusively DMD cohorts. Three studies involved portable monitoring (PM).
CONCLUSIONS
PSG with transcutaneous CO2 capnography is an important part of the clinical care for those with DMD. The utility of PM in DMD is unclear with only 1 study to date comparing PSG to PM data. Initiation of PAP therapy using bilevel modality may prevent the need for device switching as the disease progresses.
研究目的
本综述旨在回顾有关杜氏肌营养不良症（DMD）睡眠呼吸障碍的文献。
方法
使用一系列检索词在PubMed上进行检索，包括“阻塞性睡眠呼吸暂停（OSA）”、“阻塞性睡眠呼吸暂停”、“睡眠呼吸障碍”、“肌营养不良症”、“神经肌肉”、“杜氏肌营养不良症”、“多导睡眠图”和“便携式监测”。对所有相关文章进行了讨论。
结果
回顾了18篇研究文章和1份共识声明，并根据所呈现的相关数据进行了评估。1990年之前的三项早期研究评估了与DMD相关的阻塞性睡眠呼吸暂停。五项研究评估了不同神经肌肉疾病中的气道正压通气（PAP）和/或睡眠情况，其中包括一个DMD队列。自2000年以来的六项研究仅在DMD队列中纳入了多导睡眠图（PSG）数据。三项研究涉及便携式监测（PM）。
结论
采用经皮二氧化碳监测的PSG是DMD患者临床护理的重要组成部分。PM在DMD中的效用尚不清楚，迄今为止仅有1项研究比较了PSG与PM数据。随着疾病进展，采用双水平模式启动PAP治疗可能避免设备更换的需要。
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