印度人群阻塞性睡眠呼吸暂停患者持续气道正压通气估计方程的确定。
Determination of equation for estimating continuous positive airway pressure in patients with obstructive sleep apnea for the Indian population.
作者信息
Sarma Latha, Putti Nandan, Alias Kapil, Chilana Mohit
机构信息
Department of Pulmonology, KIMS Hospital, Secunderabad, Telangana, India.
出版信息
Lung India. 2020 Sep-Oct;37(5):411-414. doi: 10.4103/lungindia.lungindia_322_19.
BACKGROUND
Continuous positive airway pressure (CPAP) is the treatment of obstructive sleep apnea (OSA). The CPAP pressure is generally estimated by manual titration or an auto CPAP device. An alternative method involves the use of the predictive equation.
AIM AND OBJECTIVE
There is no equation developed, taking into account the Indian population. The aim is to develop a predictive equation for optimal CPAP pressure in patients with OSA and to validate the equation by comparing it with manual titration pressure.
MATERIALS AND METHODS
A total of 250 patients with OSAS who underwent successful manual titration for CPAP treatment in a tertiary care center were included in this study and divided randomly into two groups A and B with 150 and 100 patients, respectively. Stepwise multiple regression analysis was applied to anthropometric and polysomnographic variables of group A and the predictive equation for estimating CPAP was developed using SPSS. This equation was validated by comparing the estimated pressure with that of manual titration pressure in Group B.
RESULTS
The mean age was 55.09 ± 11.43 and mean body mass index (BMI) was 33.69 ± 6.56. CPAP pressure in patients with OSA was 11.13 ± 1.83 cm HO. The Apnea Hypopnea index (AHI) (r = 0.595, P < 0.001), minimal; SpO (r = -0.502, P < 0.001), BMI (r = 0.494, P < 0.001) significantly correlated with optimal CPAP level. A predictive equation for optimal CPAP level in patients with OSA was developed using AHI, BMI, and minimal SpO, which can be easily measured during the diagnostic process. Optimal CPAP level (cm HO) =8.401+ (0.053 × BMI) + (0.020 × AHI) - (0.031 × lowest oxygen). Twenty-six percent of the variance in the optimal CPAP level was explained by this equation (R = 0.26, P < 0.001) and the equation showed 86% of optimal estimation.
CONCLUSION
The results suggest that manual titration pressure correlates with the pressure derived from the predictive equation in our study.
背景
持续气道正压通气（CPAP）是治疗阻塞性睡眠呼吸暂停（OSA）的方法。CPAP压力通常通过人工滴定或自动CPAP设备来估计。另一种方法是使用预测方程。
目的
尚未有考虑印度人群的方程。目的是为OSA患者建立最佳CPAP压力的预测方程，并通过与人工滴定压力进行比较来验证该方程。
材料与方法
本研究纳入了在一家三级医疗中心成功接受CPAP治疗人工滴定的250例OSAS患者，并随机分为A组和B组，分别有150例和100例患者。对A组的人体测量和多导睡眠图变量进行逐步多元回归分析，并使用SPSS建立估计CPAP的预测方程。通过将B组的估计压力与人工滴定压力进行比较来验证该方程。
结果
平均年龄为55.09±11.43，平均体重指数（BMI）为33.69±6.56。OSA患者的CPAP压力为11.13±1.83 cm HO。呼吸暂停低通气指数（AHI）（r = 0.595，P < 0.001）、最低血氧饱和度（r = -0.502，P < 0.001）、BMI（r = 0.494，P < 0.001）与最佳CPAP水平显著相关。使用AHI、BMI和最低血氧饱和度建立了OSA患者最佳CPAP水平的预测方程，这些指标在诊断过程中易于测量。最佳CPAP水平（cm HO）= 8.401 +（0.053×BMI）+（0.020×AHI）-（0.031×最低血氧饱和度）。该方程解释了最佳CPAP水平26%的方差（R = 0.26，P < 0.001），且该方程显示出86%的最佳估计。
结论
结果表明，在我们的研究中，人工滴定压力与预测方程得出的压力相关。
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