持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者心血管事件影响的meta分析  

Effect of CPAP therapy on cardiovascular events and mortality in patients with obstructive sleep apnea: a meta analysis

作　　者：李松桃[1] 方明亮[2] 郭华[1] 胡玲[1] 代平[1] 余阗[1] 王莹[1] 杨炜[1] Li Songtao;Fang Mingliang;Guo Hua;Hu Ling;Dai Ping;Yu Tian;Wang Ying;Yang Wei(Department of Respiratory Medicine, the 6th People′s Hospital of Chengdu, Chengdu 610051, China;Department of Cardrovascular Medicine, the Second People′s Hospital of Chengdu, Chengdu 610017, China)

机构地区：[1]成都市第六人民医院呼吸科,610051 [2]成都市第二人民医院心内科,610017

出　　处：《国际呼吸杂志》2019年第6期422-428,共7页International Journal of Respiration

摘　　要：目的评价持续气道正压通气对阻塞性睡眠呼吸暂停综合征(OSA)患者发生心血管事件的影响。方法利用计算机检索PubMed、Medline、Cochrane以及万方、维普、CNKI数据库,检索年限为数据库自建库到2017年10月。检索应用持续气道正压通气(CPAP)治疗阻塞性睡眠呼吸暂停综合征患者(CPAP组)对比未使用持续正压通气治疗阻塞性睡眠呼吸暂停综合征患者(对照组)发生心脑血管事件、死亡率的中英文文献,通过纳入标准、排除标准入选合格文献并进行质量评价。使用Rev Man 5.3软件进行分析。结果共纳入18项研究,共33 256例患者,其中有CPAP组6 260例,对照组26 996例。荟萃分析结果显示CPAP组与对照组相比全因死亡率、心源性死亡率、卒中发生率差异有统计学意义(P<0.05),合并比值比(OR)及95%置信区间(CI)依次为:0.57(0.43,0.75),0.39(0.24,0.63),0.51(0.30,0.86);两组非致死性心肌梗死发生率、心力衰竭发生率差异无统计学意义(P>0.05)。结论OSA患者给予CPAP治疗能降低卒中发生率,降低心源性死亡率及全因死亡率;但对非致死性心肌梗死和心力衰竭的发生无明显改善。Objective To investigate the effect of continuous positive airway pressure (CPAP) therapy on cardiovascular events and mortality in patients with obstructive sleep apnea (OSA). Methods By using the computer to search PubMed, Medline, Cochrane Library and Wanfang database, Vip database and CNKI database, the retrieval period was from inception of the database to October 2017.Qualified literature was selected through inclusion criteria and exclusion criteria, and quality evaluation was conducted, followed by meta analysis using Rev Man 5.3 software. Results There were 18 studies including 33 256 cases (CPAP group 6 260, control group 26 996) met the inclusion criteria.Results of analysis showed that there showed significant differences in all cause mortality, cardiovascular mortality and stroke incidence between the CPAP group and the control group (P<0.05). The odds radio (OR) and 95% confidence intervals (CI) were 0.57(0.43, 0.75), 0.39(0.24, 0.63), 0.51(0.30, 0.86)respectively.However, there showed no significant difference in the incidence rate of nonfatal myocardial infarction and heart failure (P>0.05). Conclusions CPAP treatment for OSA patients can reduce the incidence of stroke, cardiac mortality and all-cause mortality.However, there showed no significant improvement in the occurrence of non-fatal myocardial infarction and heart failure.

关 键 词：持续正压通气 睡眠呼吸暂停 心血管事件 死亡率 META分析 

分 类 号：R766[医药卫生—耳鼻咽喉科]