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慢性心力衰竭患者的血氧、睡眠呼吸障碍与呼吸不稳定 - PROST亚组分析

Blood Oxygen, Sleep Disordered Breathing, and Respiratory Instability in Patients With Chronic Heart Failure - PROST Subanalysis.

作者信息

Tobushi Tomoyuki, Kadokami Toshiaki, Takagawa Junya, Dohi Kaoru, Joho Shuji, Wada Osamu, Momomura Shin-Ichi, Koyama Takashi, Haruki Nobuhiko, Ando Shin-Ichi, Asanoi Hidetsugu

机构信息

Cardiovascular Medicine, Fukuokaken Saiseikai Futsukaichi Hospital Fukuoka Japan.

Cardiology Division, Imizu Municipal Hospital Toyama Japan.

出版信息

Circ Rep. 2019 Sep 28;1(10):414-421. doi: 10.1253/circrep.CR-19-0068.

Abstract

Respiratory stability index (RSI), a semi-quantitative measure of respiratory instability, was found to reflect congestive and other clinical status of acutely decompensated heart failure in the PROST study. Given that the association between RSI and another important factors affecting respiration, such as peripheral oxygen saturation (SpO), and the influence of oxygen inhalation on this association were undetermined, and that the association between common sleep-disordered breathing (SDB) parameters and RSI was unknown, we performed a subanalysis using PROST data. Correlation analyses were performed to evaluate the relationships between RSI, SpO, and other SDB parameters (3% oxygen desaturation index [3%ODI], respiratory disturbance index [RDI]) using Spearman's rank correlation. RSI and overnight mean SpO were not significantly correlated either after admission (n=38) or before discharge (n=36; r=0.27, P=0.10 and r=0.05, P=0.76, respectively). This correlation was also not affected by presence or absence of oxygen inhalation. 3%ODI, RDI and RSI were significantly and inversely correlated both after admission and before discharge. RSI and blood oxygen level were not significantly correlated irrespective of oxygen inhalation, while the SDB parameters were significantly correlated, suggesting that RSI reflects lung congestion independently of blood oxygen concentration and, thus, can be a useful indicator of the non-invasive assessment of lung congestion.

摘要

呼吸稳定性指数(RSI)是一种衡量呼吸不稳定的半定量指标,在PROST研究中发现它可反映急性失代偿性心力衰竭的充血及其他临床状况。鉴于RSI与其他影响呼吸的重要因素(如外周血氧饱和度(SpO))之间的关联以及吸氧对此关联的影响尚不确定,且常见睡眠呼吸障碍(SDB)参数与RSI之间的关联也未知,我们使用PROST数据进行了一项亚分析。采用Spearman等级相关性分析来评估RSI、SpO和其他SDB参数(3%氧饱和度下降指数[3%ODI]、呼吸紊乱指数[RDI])之间的关系。入院后(n = 38)或出院前(n = 36;r分别为0.27,P = 0.10和r = 0.05,P = 0.76),RSI与夜间平均SpO均无显著相关性。这种相关性也不受是否吸氧的影响。入院后和出院前,3%ODI、RDI与RSI均呈显著负相关。无论是否吸氧,RSI与血氧水平均无显著相关性,而SDB参数之间显著相关,这表明RSI独立于血氧浓度反映肺充血情况,因此可作为无创评估肺充血的有用指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eef7/7897548/3505762b57d3/circrep-1-414-g001.jpg

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