药物诱导睡眠内镜检查中治疗性气道正压与上气道塌陷性的关系
The Relationship of Therapeutic Positive Airway Pressure and Upper Airway Collapsibility During Drug-Induced Sleep Endoscopy.
文献信息
| PMID | 42748373 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Julio A Roque Buenrostro |
| 作者单位 | Rush Medical College, Chicago, Illinois, USA. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 药物诱导睡眠内镜检查联合气道正压（DISE-PAP）可对上气道塌陷性进行定量评估，即咽开放压（PhOP）。关于PhOP与治疗性持续气道正压（CPAP）之间关系的研究有限。本研究探讨了治疗性CPAP水平与PhOP之间的关系。
研究设计： 回顾性队列研究。
研究场所： 单一学术教学医院。
方法： 本研究评估了年龄≥18岁、患有阻塞性睡眠呼吸暂停（AHI ≥ 5）、于2022年至2024年期间接受DISE-PAP、平均PAP使用时间>2小时/天且PAP治疗下OSA控制良好的成人。主要结局为CPAP中位水平（mCPAP）、95%时间CPAP水平（t95CPAP）与PhOP之间的关系。次要结局确定了mCPAP、t95CPAP和PhOP与AHI和BMI之间的关系。
结果： 共纳入94例患者（年龄50.5 ± 15.1岁，BMI 29.9 ± 4.4 kg/m2，AHI 35.3 ± 23.3次/小时）。平均PhOP为7.1 ± 2.9 cmH2O，mCPAP为8.5 ± 2.4 cmH2O，t95CPAP为10.3 ± 2.5 cmH2O。PhOP与mCPAP之间存在正相关。PhOP分别比mCPAP和t95CPAP低1.5和3.3 cmH2O。当mCPAP和t95CPAP每增加1个单位时，PhOP分别增加0.33和0.36 cmH2O。BMI和AHI与mCPAP呈轻度相关；AHI每增加10个点，mCPAP和PhOP分别增加0.4和0.3 cmH2O。然而，AHI与PhOP之间的关联未达到统计学显著性。
结论： mCPAP、t95CPAP与PhOP之间存在正相关，且PhOP低于治疗性CPAP水平。这些发现可能使外科医生在无法进行DISE-PAP时，利用治疗性CPAP水平来估计上气道塌陷性并确定手术干预措施。
证据等级： 4级。
英文摘要
OBJECTIVE: Drug-Induced Sleep Endoscopy with Positive Airway Pressure (DISE-PAP) provides quantitative evaluation of upper airway collapsibility, known as pharyngeal opening pressure (PhOP). Limited research exists on the relationship between PhOP and therapeutic continuous positive airway pressure (CPAP). This study investigated the relationship between therapeutic CPAP level and PhOP.
STUDY DESIGN: Retrospective cohort study.
SETTING: Single academic teaching hospital.
METHODS: This study evaluated adults ≥18 years with obstructive sleep apnea (AHI ≥ 5) who underwent DISE-PAP from 2022 to 2024, had >2 h/d average PAP use, and well-controlled OSA on PAP. Primary outcome was the relationship between median CPAP level (mCPAP), CPAP level at 95% of time (t95CPAP), and PhOP. Secondary outcomes determined relationships between mCPAP, t95CPAP, and PhOP with AHI and BMI.
RESULTS: Ninety-four patients were included (age 50.5 ± 15.1 years, BMI 29.9 ± 4.4 kg/m2, AHI 35.3 ± 23.3 events/h). Mean PhOP was 7.1 ± 2.9 cmH2O, mCPAP 8.5 ± 2.4 cmH2O, and t95CPAP 10.3 ± 2.5 cmH2O. Positive correlation existed between PhOP and mCPAP. PhOP was 1.5 and 3.3 cmH2O lower than mCPAP and t95CPAP, respectively. As mCPAP and t95CPAP increased by 1 unit, PhOP increased by 0.33 and 0.36 cmH2O. BMI and AHI were mildly correlated with mCPAP; for each 10-point increase in AHI, mCPAP and PhOP increased by 0.4 and 0.3 cmH2O, respectively. However, the association between AHI and PhOP did not reach statistical significance.
CONCLUSION: Positive correlation exists between mCPAP, t95CPAP, and PhOP, with PhOP lower than therapeutic CPAP levels. These findings may allow surgeons to use therapeutic CPAP levels when DISE-PAP is unavailable to estimate upper airway collapsibility and determine surgical interventions.
LEVEL OF EVIDENCE: Level 4.