阻塞性睡眠呼吸暂停在间质性肺疾病人群中的预后意义

IF 2.3 Q2 RESPIRATORY SYSTEM Pulmonary Therapy Pub Date : 2023-06-01 DOI:10.1007/s41030-023-00215-1

Debora Valecchi, Elena Bargagli, Maria Grazia Pieroni, Metella Rosa Refini, Piersante Sestini, Paola Rottoli, Andrea S Melani

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引用次数: 0

摘要

梗阻性睡眠呼吸暂停(OSA)常见于间质性肺疾病(ILD)患者。它可能对ILD的病程有负面影响，但其与其他已知不良预后指标的预后意义尚不清楚。方法:经过详细的随访，包括通宵无人值勤的III型测谎，所有到我们诊所就诊的新诊断为ild的受试者随访至少1.5年或直到死亡或疾病进展[> 10%的用力肺活量(FVC)低于基线]。我们分析了一些预先指定的感兴趣的变量之间的关系，包括睡眠结果，以建立预测进展过程的参数。结果:我们的人群包括46名受试者(平均年龄59.6岁;男性61%);23.9%和41%分别有特发性肺纤维化和与全身性疾病相关的ILD。平均基线强迫肺活量和一氧化碳扩散量分别为预测的83%和57%。平均(±SE)呼吸暂停低通气指数(AHI)为17(±3)次/小时。AHI在5-14.9、15-29.9和≥30之间的受试者分别为14例(31%)、6例(13%)和9例(20%)。6-MWG步行测试(6MWT)的平均行走距离为302(±19)m, 26例(57%)受试者表现为劳累性血红蛋白失饱和。中位随访时间约为18个月。多因素logistic回归分析显示，运动去饱和(HR 8.2;1.8-36.5 95% ci;p = 0.006)， AHI≥30，即重度OSA的阈值(HR 7.5;1.8 - -30.6;P = 0.005)，是唯一与病程进展相关的自变量。结论:我们得出结论，在我们的ILD人群中，运动去饱和和AHI升高具有独立的负面预后意义。

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Prognostic Significance of Obstructive Sleep Apnea in a Population of Subjects with Interstitial Lung Diseases.

Introduction: Obstructive sleep apnea (OSA) is often observed in subjects with interstitial lung disease (ILD). It may have a negative impact on the course of ILD, but its prognostic significance in relation to other known indicators of poor outcome is unclear.

Methods: After a detailed work-up, including overnight unattended type III polygraphy, all subjects newly diagnosed with ILDs referred to our clinics were followed-up for at least 1.5 years or until death or progression of disease [> 10% decline in forced vital capacity (FVC) below baseline]. We analyzed relationships between some prespecified variables of interest, including sleeping results, to establish parameters predictive of progressive course.

Results: Our population consisted of 46 subjects (mean age 59.6 years; males 61%); 23.9% and 41% had idiopathic pulmonary fibrosis and ILD associated with systemic diseases, respectively. Mean baseline forced vital capacity and diffusion capacity of carbon monoxide were 83% and 57% of predicted, respectively. Mean (± SE) Apnea-Hypopnea Index (AHI) was 17 (± 3) events/h. AHI in the ranges 5-14.9, 15-29.9, and ≥ 30 was recorded in 14 (31%), 6 (13%), and 9 (20%) subjects, respectively. Mean distance covered in the 6-MWG walk test (6MWT) was 302 (± 19) m and 26 subjects (57%) showed exertional oxyhemoglobin desaturation. The median follow-up was about 18 months. Multivariate logistic regression analysis showed that exertional desaturation (HR 8.2; 1.8-36.5 95% CI; p = 0.006) and AHI ≥ 30, namely the threshold of severe OSA (HR 7.5; 1.8-30.6; p = 0.005), were the only independent variables related to progressive disease course.

Conclusion: We conclude that exertional desaturation and elevated AHI had independent negative prognostic significance in our ILD population.

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来源期刊

Pulmonary Therapy Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Pulmonary Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the use of pulmonary therapies, devices, and surgical techniques. Areas of focus include, but are not limited to: asthma; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; pulmonary hypertension; cystic fibrosis; lung cancer; respiratory tract disorders; allergic rhinitis and other respiratory allergies; influenza, pneumococcal infection, respiratory syncytial virus and other respiratory infections; and inhalers and other device therapies. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Pulmonary Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of pulmonary therapies. Open Access All articles published by Pulmonary Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. 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