Sleep apnea in patients with acromegaly. Frequency, characterization and positive pressure titration.
Sleep apnea in patients with acromegaly. Frequency, characterization and positive pressure titration.
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DOI：
10.2174/1874306401206010028
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Torre-Bouscoulet L
中科院分区：
文献类型：
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作者：
Hernández-Gordillo D;Ortega-Gómez Mdel R;Galicia-Polo L;Castorena-Maldonado A;Vergara-López A;Guillén-González MÁ;Torre-Bouscoulet L
描述肢端肥大症患者睡眠呼吸暂停的频率；确定气道正压治疗候选者的比例；报告我们在肢端肥大症患者正压滴定过程中的经验。一项横断面研究，包括墨西哥城国家医学中心11月20日的肢端肥大症队列（n=44）。对每位患者进行标准的多导睡眠图（PSG）检查。第二次PSG用于CPAP滴定。共研究了35例患者（80%的队列，20例[57%]女性）。多导睡眠图结果显示，34例（97%,95%CI 91 ~ 100%）患者的呼吸暂停低通气指数(AHI)≥5。无患者出现中心性呼吸暂停。我们确定了19例AHI≥5和Epworth≥10的受试者，阻塞性睡眠呼吸暂停综合征的发生率为54% （95%CI 36-71%）。共有31例患者（88%;95%CI 77-99%）被认为是正压治疗的候选人，但其中只有8例接受了CPAP。他们需要的压力范围在10到18 cmH2O之间。我们的研究结果证实，肢端肥大症患者睡眠呼吸暂停的患病率很高，并提供证据表明，大多数患者都适合正压治疗。与报道相反，我们没有发现中枢性呼吸暂停患者。
to describe the frequency of sleep apnea in patients with acromegaly; to identify the proportion of candidates for treatment with positive airway pressure; to report our experience with the positive pressure titration process in acromegaly patients. A cross-sectional study that included the acromegaly cohort at the Centro Medico Nacional “20 de Noviembre” in Mexico City (n=44). A standard polysomnography (PSG) was carried out for each patient. A second PSG was done for purposes of CPAP titration. A total of 35 patients were studied (80% of the cohort, 20 [57%] women). Polysomnography results showed that 34 subjects (97%, 95%CI 91-100%) had apnea hypopnea indexes (AHI) ≥ 5. No patient had central apnea. We identified 19 subjects with AHI ≥5 and Epworth ≥10, for a frequency of obstructive sleep apnea syndrome of 54% (95%CI 36-71%). A total of 31 patients (88%; 95%CI 77-99%) were deemed to be candidates for positive pressure treatment, but only 8 of them accepted CPAP. They required pressures that ranged from 10 to 18 cmH2O. Our results confirm a high prevalence of sleep apnea in patients with acromegaly, and provide evidence that the majority of those patients are candidates for treatment with positive pressure. Contrary to what has been reported, we identified no patients with central apnea.