持续气道正压通气对老年阻塞性睡眠呼吸暂停患者心脑血管事件的影响

目的 探讨持续气道正压通气(CPAP)治疗对老年阻塞性睡眠呼吸暂停综合征(OSAS)患者心脑血管事件的远期作用.方法 采用前瞻性队列研究对2000至2006年间诊断为中重度OSAS的老年患者进行随访,共纳入106例患者,其中男91例(85.8%),女 15 例(14.2%),年龄60～86岁,平均(73±6)岁,其中坚持进行CPAP治疗者34例,对照组72例,比较CPAP治疗与未治疗2组的心脑血管事件发生率.结果 全部受访的老年中重度OSAS患者接受随访平均观察时间3.5年,到随访结束,CPAP治疗组心脑血管事件的发生率为12%(4/34),对照组为47%(34/72),差别有统计学意义(P<0.001).经Kaplan-Meier生存分析结果显示,随访时间越长,对照组发生心脑血管事件的风险明显高于治疗组(χ2=17.0,P<0.01),是否接受CPAP治疗与心脑血管事件发生呈正相关.结论 合并中重度OSAS的老年心血管疾病患者在接受基础疾病治疗的同时,采用CPAP治疗睡眠呼吸暂停,可以减少心脑血管事件发生的风险,从而利于改善预后.

Investigation on long-term efficacy of CPAP treatment for the elderly with obstructive sleep apnea syndrome

Objective To investigate the long-term efficacy of continuous positive airway pressure (CPAP)treatment for the elderly with obstructive sleep apnea syndrome (OSAS). Methods Case control study was performed among 106 elderly with obstructive sleep apnea syndrome (OSAS). They were divided into treatment group (n =34) and control group (n = 72), based on whether they underwent long-term CPAP treatment or not. The long-term efficacy of CPAP treatment was evaluated by long-term clinical observation. Results The incidence of cardiovascular events was 12%(4/34) in treatment group and 47%(34/72) in control group (P <0. 01). Kaplan-Meier survival analysis showed that after controlling the factors of age, sex, body mass index, apnea hypopnea index and previous diseases, failing to receive CPAP treatment was the independent risk factor for cardiovascular events (χ2 = 17.0, P < 0.01). Conclusions CPAP treatment for moderate - severe OSAS could reduce cardiovascular and neurovascular events risk for elderly patients with OSAS.