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肺动脉高压合并阻塞性睡眠呼吸暂停患者的临床特征。

The clinical characteristics of patients with pulmonary hypertension combined with obstructive sleep apnoea.

机构信息

Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 BeiLiShi Road, Xicheng District, Beijing, 100037, China.

出版信息

BMC Pulm Med. 2021 Nov 21;21(1):378. doi: 10.1186/s12890-021-01755-5.

Abstract

OBJECTIVE

Obstructive sleep apnoea (OSA) is one cause of pulmonary hypertension (PH) and can also emerge along with PH. The clinical diagnosis and treatment of OSA in patients with PH are still controversial. The purpose of this clinical observation study was to observe and summarize the incidence and clinical characteristics of OSA in patients with PH and to explore possible predictors of PH combined with OSA.

METHODS

Patients with PH diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from December 2018 to December 2020 were enrolled. OSA was defined as an apnoea-hypopnoea index of ≥ 5/h with ≥ 50% of apnoeic events being obstructive. Baseline clinical characteristics and parameters were collected to compare PH patients with and without OSA. Logistic regression analysis was run to determine the risk factors for OSA in PH patients.

RESULTS

A total of 35 (25%) of 140 patients had OSA. OSA is relatively frequent in patients with PH, especially in patients with chronic thromboembolic pulmonary hypertension and patients with lung disease- or hypoxia-associated PH. The patients who had OSA were mostly male and had a higher age and a lower daytime arterial oxygen pressure. Logistic regression analysis found that older age, male sex, and lower daytime arterial blood oxygen pressure correlated with OSA in PH patients.

CONCLUSION

OSA is common in patients with PH. Lower daytime arterial oxygen pressure is a risk factor for OSA in older male patients with PH.

摘要

目的

阻塞性睡眠呼吸暂停(OSA)是肺动脉高压(PH)的一个病因,也可能与 PH 同时出现。PH 患者中 OSA 的临床诊断和治疗仍存在争议。本临床观察研究的目的是观察和总结 PH 患者中 OSA 的发生率和临床特征,并探讨 PH 合并 OSA 的可能预测因素。

方法

纳入 2018 年 12 月至 2020 年 12 月通过右心导管检查诊断为 PH 并进行过夜心肺监测的患者。OSA 定义为呼吸暂停-低通气指数≥5/h,且≥50%的呼吸暂停事件为阻塞性。收集基线临床特征和参数,比较 PH 患者伴或不伴 OSA 的情况。运行逻辑回归分析以确定 PH 患者 OSA 的危险因素。

结果

共 140 例患者中有 35 例(25%)患有 OSA。OSA 在 PH 患者中较为常见,尤其是在慢性血栓栓塞性肺动脉高压和肺疾病或缺氧相关 PH 患者中。患有 OSA 的患者大多为男性,年龄较大,日间动脉血氧分压较低。逻辑回归分析发现,年龄较大、男性和日间动脉血氧分压较低与 PH 患者的 OSA 相关。

结论

OSA 在 PH 患者中很常见。较低的日间动脉血氧分压是老年男性 PH 患者 OSA 的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b35f/8607599/f48a44d7077e/12890_2021_1755_Fig1_HTML.jpg

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