Park So Young, Yoo Kwang Ha, Park Yong Bum, Rhee Chin Kook, Park Jinkyeong, Park Hye Yun, Hwang Yong Il, Park Dong Ah, Sim Yun Su
Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2022 Jan;85(1):47-55. doi: 10.4046/trd.2021.0062. Epub 2021 Nov 15.
We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD).
Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients.
The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94).
Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.
我们评估了家庭无创正压通气（NIPPV）用于治疗慢性阻塞性肺疾病（COPD）患者的长期效果。
检索数据库以确定使用NIPPV治疗COPD超过1年的随机对照试验。死亡率是该荟萃分析的主要结局指标。本研究纳入的八项试验包含了913例患者的数据。
NIPPV组和对照组的死亡率分别为29%（118/414）和36%（151/419），提示存在统计学显著差异（风险比[RR]，0.79；95%置信区间[CI]，0.65 - 0.95）。在四项纳入稳定期COPD患者的试验中，NIPPV降低了死亡率。NIPPV组和对照组在住院率、急性加重和生活质量方面无差异。两组的退出率无显著差异（RR，0.99；95%CI，0.72 - 1.36；p = 0.94）。
与长期氧疗相比，维持夜间NIPPV治疗超过1年，尤其是在稳定期COPD患者中，可降低死亡率，且不增加退出率。
