用巴韦诺分类法看待 OSAS 病例的新视角。

Postgraduate medicine Pub Date : 2024-08-01 Epub Date: 2024-07-15 DOI:10.1080/00325481.2024.2379759
Handan Inonu Koseoglu, Gökhan Aykun, Asiye Kanbay, Ahmet Cemal Pazarli, Halil İbrahim Yakar, Osman Demir
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摘要

目的/背景:由于用于诊断和分级 OSAS 的呼吸暂停-低通气指数(AHI)不能充分反映该疾病的临床表现,因此开发了 OSA 的巴韦诺分类法,可对 OSAS 患者进行多成分评估。我们的研究旨在评估巴韦诺分类法在临床实践中的应用情况:我们对 2021 年 1 月至 2022 年 6 月期间确诊的 OSAS 患者进行了前瞻性研究。根据巴韦诺分类法将患者分为 4 组(A-D 组),根据 AHI 将患者分为轻度、中度和重度 OSAS 三组:共有 378 名患者(70% 为男性,平均年龄(48.68 ± 11.81)岁)参与了研究。患者的 OSAS 分为轻度(75 人,占 20%)、中度(88 人,占 23%)和重度(215 人,占 57%)。根据贝文诺分类法,患者被分为 A 组(n:90; 24%)、B 组(n:105; 28%)、C 组(n:65; 17%)和 D 组(n:118; 3 1% )。Baveno 组的平均 AHIs 相似(p = 0.116)。与 A 组相比,B 组和 D 组的氧饱和度指数(ODI)更高:巴韦诺分类法将我们的 OSAS 病例分为同等组别。每四名轻度 OSAS 患者中就有一名属于 D 组。这一数据值得注意,因为巴韦诺分类法可以根据 AHI 识别有症状和合并症的轻度 OSAS 患者,并对这些患者采取更有效的治疗方法。有合并症的患者夜间出现氧饱和度降低的时间更长,而症状突出的患者氧饱和度会恶化。在临床实践中,巴韦诺分类法被认为是一种更合理、更易于应用的方法。
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A new perspective on OSAS cases with the Baveno classification.

Objective/background: Since the apnea-hypopnea index (AHI), which is used in the diagnosis and grading of OSAS, does not adequately reflect the clinical perspective of the disease, the Baveno classification of OSA was developed, which allows multicomponent evaluation of OSAS patients. The aim of our study was to evaluate the application of the Baveno classification in clinical practice.

Patients/methods: A prospective study was performed on patients diagnosed with OSAS between January 2021 and June 2022. Patients were divided into 4 groups according to Baveno classification (Groups A-D) and three groups as mild, moderate, and severe OSAS according to AHI.

Results: A total of 378 patients (70% male, mean age 48.68 ± 11.81 years) were included in the study. The patients had mild (n: 75; 20%), moderate (n: 88; 23%), and severe (n: 215; 57%) OSAS. According to Baveno classification, patients were included in Groups A (n: 90; 24%), B (n: 105 (28%), C (n: 65; 17%), and D (n: 118; 31%). The mean AHIs of the Baveno groups were similar (p = 0.116). Oxygen desaturation index (ODI) was higher in Groups B and D compared to Group A. The duration of T90 desaturation was longer in Groups C and D compared to Groups A and B (p < 0.05).

Conclusions: The Baveno classification divided our OSAS cases into equivalent groups. One out of every four patients with mild OSAS was in Group D. This data was noteworthy in that the Baveno classification allows for the identification of symptomatic and comorbid patients with mild OSAS according to AHI and for the application of more effective treatments to these patients. Patients with comorbidities experienced oxygen desaturation for a longer period of time at night, and oxygenation deteriorated in patients with prominent symptoms. Baveno classification was found to be a more reasonable and easily applicable approach in clinical practice.

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