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Thorax:肥胖低通气综合征患者采用无创通气和CPAP治疗后的超声心动图改变!

2017-11-17 xing.T MedSci原创

对于OHS患者,中期NIV治疗比CPAP和生活方式能更有效地改善肺动脉高压、左心室肥厚和功能结局,需要长期研究来证实这些结果。

尽管肥胖低通气综合征(OHS)与心功能不全有着显著的相关性,但还没有随机试验来评估无创通气(NIV)或CPAP对超声心动图评估的心脏结构和功能的影响。近日,呼吸系统领域权威杂志Thorax上针对这一问题发表了一篇研究文章。

研究人员对OHS(Pickwick项目,n=221)最大的多中心随机对照试验的数据进行二次分析,以确定2个月NIV(n=71)、CPAP(n=80)和生活方式(对照组,n=70)对结构性和功能性超声心动图指标变化的影响。

研究人员获得了受试者基线和2个月后传统的经胸二维和多普勒超声心动图,每个部位的超声心动图人员对治疗分组不知情,统计分析方法采用意向治疗分析。

在研究之初,55%的患者有肺动脉高压,51%有左心室肥厚的证据。采用NIV而不是CPAP治疗会降低肺动脉收缩压(-3.4mmHg,95%可信区间为-5.3至-1.5;相比于对照组,调整的P=0.025,相对于CPAP,调整的P=0.033)。接受NIV治疗的基线时患有肺动脉高压的患者,收缩期肺动脉压的改善程度更大(-6.4mmHg,95%可信区间为-9至-3.8)。只有NIV治疗可以减轻左心室肥厚,左心室重量指数显著下降(-5.7g/m2; 95%可信区间为-11.0至-4.4)。经过校正分析后,NIV在改善左心室重量指数方面优于对照组(P=0.015)。只有NIV治疗可以显著改善6min步行距离(32m; 95%可信区间为19-46)。

对于OHS患者,中期NIV治疗比CPAP和生活方式能更有效地改善肺动脉高压、左心室肥厚和功能结局,需要长期研究来证实这些结果。

原始出处:
 
Jaime Corral, et al. Echocardiographic changes with non-invasive ventilation and CPAP in obesity hypoventilation syndrome.thorax. 2017. http://dx.doi.org/10.1136/thoraxjnl-2017-210642
 
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    2018-03-20 owlhealth

    不错耶.学习了

    0

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    2017-11-19 zhouqu_8
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