肺栓塞患者合并阻塞性睡眠呼吸暂停发病率及危险因素Meta分析  

The Incidence and Risk Factors of Combined Obstructive Sleep Apnea in Patients with Pulmonary Embolism:A Meta-analysis.

作　　者：吕琴[1] 何雅 高慎敏 Lv Qin;He Ya;Gao Shenmin(Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu,Sichuan 610072,China.)

机构地区：[1]四川省医学科学院·四川省人民医院呼吸与危重症医学科,四川成都610072

出　　处：《四川医学》2023年第4期349-355,共7页Sichuan Medical Journal

基　　金：四川省卫生健康委员会医学科技项目(编号:21PJ076)。

摘　　要：目的系统评价肺栓塞患者合并阻塞性睡眠呼吸暂停的发病率、危险因素和相关性,以期为针对性干预和预防决策提供参考。方法计算机检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、中华医学期刊全文数据库、EMBASE、PubMed、Web of Science、Cochrane Library、CINAHL等国内外数据库,收集肺栓塞合并阻塞性睡眠呼吸暂停患者危险因素有关病例的对照和队列研究,检索时间为建库至2022年7月31日。由2名评价者按照纳入与排除标准对所获的文献独立进行文献筛选、资料提取和方法学质量评价后,采用STATA 16.0软件进行Meta分析。结果最终共纳入11篇文献,共计纳入肺栓塞病例803373例,肺栓塞合并阻塞性睡眠呼吸暂停综合征发生率约为50%;BMI、呼吸暂停指数、年龄是肺栓塞合并阻塞性睡眠呼吸暂停综合征患者的危险因素。此外,其他因素还有高血压、纤维蛋白原、红细胞计数升高、D-二聚体升高;合并阻塞性睡眠呼吸暂停综合征并不会明显增加肺栓塞患者的死亡率。结论肺栓塞合并阻塞性睡眠呼吸暂停综合征在临床中较为多见,两者之间存在许多共同危险因素,阻塞性睡眠呼吸暂停综合征并不是肺栓塞患者死亡率的重要决定因素。Objective To systematically evaluate the prevalence,risk factors and correlates of combined obstructive sleep apnea in patients with pulmonary embolism with a view to informing targeted intervention and prevention decisions.Methods Computer searches of major Chinese and foreign language databases,such as China Knowledge Network,Vipshop database,Wanfang database,China Biomedical Literature Database,Chinese Medical Journal Full Text Database,EMBASE,PubMed,Web of Science,Cochrane Library,CINAHL,were conducted to collect risk factors related to patients with pulmonary embolism combined with obstructive sleep apnea case-control and cohort studies,searched from the date of database construction to July 31,2022.Meta-analysis was performed by two evaluators using STATA 16.0 software after independent literature screening,data extraction and methodological quality evaluation of the obtained literature according to inclusion and exclusion criteria.Results Total 11 publications were finally included,with a total of 803373 pulmonary embolism(PE)cases,and the incidence of PE combined with obstructive sleep apnea syndrome(OSA)was about 50%.BMI,AHI(apnea hyponea index),and age were risk factors for patients with PE combined with OSA.In addition,other factors were hypertension,fibrinogen,elevated red blood cell count,and elevated D-dimer.Combined OSA did not significantly increase mortality in patients with PE.Conclusion PE combined with OSA would be more common in clinical practice.There would be many common risk factors between PE and OSA,and OSA is not an important determinant of mortality in PE patients.

关 键 词：肺栓塞 阻塞性睡眠呼吸暂停 危险因素 META分析 

分 类 号：R563.5[医药卫生—呼吸系统]