持续气道正压通气对合并阻塞性睡眠呼吸暂停的心房颤动患者射频消融后复发的影响的荟萃分析  

Continuous positive airway pressure therapy affects the recurrence of atrial fibrillation in patients with obstructive sleep apnea:a systematic review and meta-analysis

作　　者：王宇鑫 罗金梅[1] 黄蓉[1] 肖毅[1] Wang Yuxin;Luo Jinmei;Huang Rong;Xiao Yi(Department of Respiratory and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中华结核和呼吸杂志》2023年第8期751-759,共9页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的心房颤动(简称房颤)与阻塞性睡眠呼吸暂停有关,多项研究分析了持续气道正压通气对房颤的作用。我们进行荟萃分析以评估持续气道正压通气对射频消融后房颤复发的作用和影响因素。方法在Pubmed、Embase、Cochrane、Web of Science、万方数据库和中国知网数据库中进行检索,检索时间段设定为各数据库建库时间至2022年10月。纳入研究包含房颤合并阻塞性睡眠呼吸暂停的患者经过射频消融后房颤复发的情况、持续气道正压通气治疗情况。应用随机效应模型合并效应值,用I2评估异质性。结果本研究共纳入8篇文章,共涉及1395例患者。荟萃分析显示持续气道正压通气使房颤的复发率降低约61%(OR=0.392,95%CI:0.267~0.576,I2=37.6%)。亚组分析显示,高血压患者(OR=0.272比0.550,95%CI:0.165~0.449比0.329~0.922)群体中,持续气道正压通气保护作用更明显。结论持续气道正压通气可使合并阻塞性睡眠呼吸暂停的房颤患者射频消融后的房颤复发率降低,且合并高血压的患者更容易获益。ObjectiveA higher incidence of atrial fibrillation is associated with obstructive sleep apnea.The effects of continuous positive airway pressure on atrial fibrillation have been studied in observational studies and randomized controlled trials.We therefore conducted this meta-analysis to assess the effect of continuous positive airway pressure on the recurrence of atrial fibrillation after radiofrequency ablation.MethodsA comprehensive search was conducted in Pubmed,Embase,Cochrane,Web of Science,Wanfang Data and CNKI databases from inception to October 2022.We included cohort studies and randomized controlled trials containing atrial fibrillation situation after catheter ablation with and without continuous positive airway pressure therapy.The random effects model was used to assess odds ratios(OR)and confidence intervals(CI).I2 was used to assess the heterogeneity.ResultsEight studies with a total of 1395 patients with obstructive sleep apnea met the inclusion criteria.Continuous positive airway pressure therapy decreased atrial fibrillation recurrence by 61%(OR=0.392,95%CI:0.267-0.576,I2=37.6%).Subgroup analysis showed that the protective effect was more significant in groups with more hypertension patients(OR=0.272 vs.0.550,95%CI:0.165-0.449 vs.0.329-0.922).ConclusionsContinuous positive airway pressure therapy reduces the recurrence rate of atrial fibrillation.Patients with hypertension are more likely to benefit from it.

关 键 词：心房颤动 睡眠呼吸暂停 阻塞性 连续气道正压通气 Meta分析 

分 类 号：R766[医药卫生—耳鼻咽喉科] R541.75[医药卫生—临床医学]