Impact of Upper Airway Characteristics on Disease Severity and CPAP Therapy in Chinese Patients With OSA: An Observational Retrospective Study.
Impact of Upper Airway Characteristics on Disease Severity and CPAP Therapy in Chinese Patients With OSA: An Observational Retrospective Study.
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DOI：
10.3389/fneur.2022.767336
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发表时间：
2022
影响因子：
3.4
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Zhang C;Chen M;Shen Y;Gong Y;Ma J;Wang G
上气道（UA）的特征对阻塞性睡眠呼吸暂停（OSA）的评估和治疗具有重要意义。本研究旨在探讨UA特征与OSA严重程度、滴定压力、持续气道正压通气（CPAP）的开始和3个月依从性之间的关系。本回顾性研究纳入了2008-2018年期间在北京大学第一医院呼吸与危重症医学科使用半定量UA评估系统（结合体格检查和清醒内镜检查）检查的连续患者。首先，比较了单纯打鼾者和轻度OSA患者与中重度OSA患者之间UA特征的差异。然后，研究UA特征对CPAP治疗开始和3个月CPAP依从性的影响。总的来说，1,002例患者被纳入，包括276例单纯打鼾者和轻度OSA组患者[呼吸暂停低通气指数（AHI）<15]和726例中重度OSA组患者（AHI ≥15）。舌根肥大、扁桃体肥大、下颌后缩、颈部环境和体重指数（BMI）是中重度OSA的独立危险因素。在这些患者中，119例患者在睡眠实验室接受CPAP滴定。悬雍垂粗长、扁桃体肥大、咽侧壁狭窄、舌肥大患者CPAP压力均高于对照组（P < 0.05）。Logistic回归分析显示，鼻甲肥大、下颌骨复位、腭后和声门后区的Müller动作阳性是开始家庭CPAP治疗的独立预测因素。UA的多部位狭窄和功能崩溃是影响OSA严重程度、CPAP滴定压力和开始家庭CPAP治疗的重要因素。清醒内窥镜检查是一种安全有效的评估OSA患者的内科方法。
The characteristics of the upper airway (UA) are important for the evaluation and treatment of obstructive sleep apnea (OSA). This study aimed to investigate the association of UA characteristics with OSA severity, titration pressure, and initiation of and 3-month compliance with continuous positive airway pressure (CPAP). This retrospective study included consecutive patients examined using a semi-quantitative UA evaluation system (combination with physical examination and awake endoscopy) during 2008–2018 at the Department of Respiratory and Critical Care Medicine, Peking University First Hospital. First, the differences in UA characteristics were compared between patients with simple snorers and mild OSA and those with moderate-to-severe OSA. Then, the effect of UA characteristics on the initiation to CPAP therapy and 3-month adherence to CPAP was conducted. Overall, 1,002 patients were included, including 276 simple snorers and patients in the mild OSA group [apnea-hypopnea index (AHI) <15] and 726 patients in the moderate-to-severe OSA group (AHI ≥15). Tongue base hypertrophy, tonsillar hypertrophy, mandibular recession, neck circumstance, and body mass index (BMI) were independent risk factors for moderate-to-severe OSA. Among those patients, 119 patients underwent CPAP titration in the sleep lab. The CPAP pressures in patients with thick and long uvulas, tonsillar hypertrophy, lateral pharyngeal wall stenosis, and tongue hypertrophy were higher than those of the control group (P < 0.05, respectively). The logistic regression analysis showed that nasal turbinate hypertrophy, mandibular retrusion, and positive Müller maneuver in the retropalate and retroglottal regions were independent predictors for the initiation of home CPAP treatment. Multisite narrowing and function collapse of the UA are important factors affecting OSA severity, CPAP titration pressure, and the initiation of home CPAP therapy. Clinical evaluation with awake endoscopy is a safe and effective way for the assessment of patients with OSA in internal medicine.
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DOI：
10.3390/bs11120180
发表时间：
2021-12-16
期刊：
Behavioral sciences (Basel, Switzerland)
影响因子：
--
作者：
Pollicina I;Maniaci A;Lechien JR;Iannella G;Vicini C;Cammaroto G;Cannavicci A;Magliulo G;Pace A;Cocuzza S;Di Luca M;Stilo G;Di Mauro P;Bianco MR;Murabito P;Bannò V;La Mantia I
通讯作者：
La Mantia I
影响因子：
--
作者：
Grewal, Gaganpreet;Joshi, Girish P
通讯作者：
Joshi, Girish P
影响因子：
1.7
作者：
Goldberg, AN;Schwab, RJ
通讯作者：
Schwab, RJ
影响因子：
4.3
作者：
Berry, Richard B.;Budhiraja, Rohit;Tangredi, Michelle M.
通讯作者：
Tangredi, Michelle M.
影响因子：
2.5
作者：
Kotecha, Bhik;De Vito, Andrea
通讯作者：
De Vito, Andrea