Sommerwerck Urte, Kleibrink Bjoern E, Kruse Frederike, Scherer Manuela J, Wang Yi, Kamler Markus, Teschler Helmut, Weinreich Gerhard
Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
Sleep Med. 2016 May;21:121-5. doi: 10.1016/j.sleep.2016.01.005. Epub 2016 Feb 11.
The aim of our study was to determine the prevalence and clinical predictors of obstructive sleep apnea in lung transplantation recipients.
In a cross-sectional analysis we studied 77 clinically stable lung transplant recipients (45 men, time range after lung transplantation [LTX]: from one month to 15 years). Indications for LTX were 36 chronic obstructive lung disease (COPD), 27 idiopathic pulmonary fibrosis (IPF), eight cystic fibrosis, and six others. In-lab polysomnography (PSG) was performed to investigate sleep characteristics. Obstructive sleep apnea (OSA) and central sleep apnea were defined by an apnea-hypopnea index (AHI) ≥ 10/h.
The prevalence of OSA and central sleep apnea (CSA) were 42.9% and 6.5%, respectively. OSA was present in 61% of patients with pre-transplant COPD and 52% of patients with pre-transplant IPF. Univariate analysis showed that OSA was significantly associated with neck circumference per 1-cm size increment (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.04-1.42, p = 0.01) and pre-transplant COPD/IPF vs other lung diseases (cystic fibrosis, pulmonary arterial hypertension, α-1 antitrypsin deficiency, and lymphangioleiomyomatosis) (OR = 6.89, 95% CI = 1.41-33.56, p = 0.02), whereas age ≥57 years (OR = 1.76, 95% CI = 0.69-4.48, p = 0.24), male gender (OR = 2.33, 95% CI = 0.89-6.01, p = 0.08), and BMI ≥ 24.6 kg/m(2) (OR = 1.73, 95% CI = 0.68-4.40, p = 0.25) did not reach a level of statistical significance. In a multivariate analysis neck circumference per 1-cm size increment (OR = 1.20, 95% CI = 1.02-1.41, p = 0.025) and pre-transplant COPD/IPF (OR = 5.34, 95% CI = 1.01-28.13, p = 0.048) remained independently associated with OSA.
The prevalence of OSA is high in stable lung transplant recipients. Pre-transplant COPD is an independent predictor of OSA.
我们研究的目的是确定肺移植受者中阻塞性睡眠呼吸暂停的患病率及临床预测因素。
在一项横断面分析中，我们研究了77例临床稳定的肺移植受者（45例男性，肺移植术后时间范围：1个月至15年）。肺移植的适应证包括36例慢性阻塞性肺疾病（COPD）、27例特发性肺纤维化（IPF）、8例囊性纤维化和6例其他疾病。进行实验室多导睡眠图（PSG）检查以研究睡眠特征。阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停由呼吸暂停低通气指数（AHI）≥10次/小时定义。
OSA和中枢性睡眠呼吸暂停（CSA）的患病率分别为42.9%和6.5%。移植前患有COPD的患者中61%存在OSA，移植前患有IPF的患者中52%存在OSA。单因素分析显示，OSA与颈围每增加1厘米显著相关（比值比[OR]=1.21，95%置信区间[CI]=1.04 - 1.42，p = 0.01），以及移植前COPD/IPF与其他肺部疾病（囊性纤维化、肺动脉高压、α-1抗胰蛋白酶缺乏症和淋巴管平滑肌瘤病）相比（OR = 6.89，95% CI = 1.41 - 33.56，p = 0.02），而年龄≥57岁（OR = 1.76，95% CI = 0.69 - 4.48，p = 0.24）、男性（OR = 2.33，95% CI = 0.89 - 6.01，p = 0.08）和体重指数（BMI）≥24.6 kg/m²（OR = 1.73，95% CI = 0.68 - 4.40，p = 0.25）未达到统计学显著水平。多因素分析中，颈围每增加1厘米（OR = 1.20，95% CI = 1.02 - 1.41，p = 0.025）和移植前COPD/IPF（OR = 5.34，95% CI = 1.01 - 28.13，p = 0.048）仍与OSA独立相关。
稳定的肺移植受者中OSA的患病率较高。移植前COPD是OSA的独立预测因素。
