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影响持续气道正压通气(CPAP)治疗长期依从性的因素——单中心经验

Factors Affecting Long-Term Compliance of CPAP Treatment-A Single Centre Experience.

作者信息

Gabryelska Agata, Sochal Marcin, Wasik Bartosz, Szczepanowski Przemysław, Białasiewicz Piotr

机构信息

Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland.

Medical Simulations Center, Medical University of Lodz, 92-213 Lodz, Poland.

出版信息

J Clin Med. 2021 Dec 27;11(1):139. doi: 10.3390/jcm11010139.

Abstract

Continuous positive airway pressure (CPAP) has been the standard treatment of obstructive sleep apnoea/hypopnoea syndrome (OSA) for almost four decades. Though usually effective, this treatment suffers from poor long-term compliance. Therefore, the aim of our one centre retrospective study was to assess factors responsible for treatment failure and long-term compliance. Four hundred subsequent patients diagnosed with OSA and qualified for CPAP treatment were chosen from our database and compliance data were obtained from medical charts. Many differing factors kept patients from starting CPAP or led to termination of treatment. Overall, almost half of patients ended treatment during the mean time of observation of 3.5 years. Survival analysis revealed that 25% of patients failed at a median time of 38.2 months. From several demographic and clinical covariates in Cox's hazard model, only the presence of a mild OSA, i.e., AHI (apnoea/hypopnoea index) below 15/h was a factor strongly associated with long term CPAP failure. The compliance results of our study are in line with numerous studies addressing this issue. Contrary to them, some demographic or clinical variables that we used in our survival model were not related to CPAP adherence.

摘要

持续气道正压通气(CPAP)近四十年来一直是阻塞性睡眠呼吸暂停/低通气综合征(OSA)的标准治疗方法。尽管该治疗通常有效,但长期依从性较差。因此,我们这项单中心回顾性研究的目的是评估导致治疗失败和长期依从性的因素。从我们的数据库中选取了400例随后被诊断为OSA且符合CPAP治疗条件的患者,并从病历中获取依从性数据。许多不同因素导致患者无法开始使用CPAP或导致治疗终止。总体而言,在平均3.5年的观察期内,几乎一半的患者终止了治疗。生存分析显示,25%的患者在中位时间38.2个月时治疗失败。在Cox风险模型中的几个人口统计学和临床协变量中,只有轻度OSA的存在,即呼吸暂停/低通气指数(AHI)低于15次/小时,是与长期CPAP治疗失败密切相关的因素。我们研究的依从性结果与众多针对该问题的研究一致。与它们不同的是,我们在生存模型中使用的一些人口统计学或临床变量与CPAP依从性无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0901/8745469/a6f8cbe6cd1e/jcm-11-00139-g001.jpg

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