综合气道正压滴定参数作为阻塞性睡眠呼吸暂停治疗依从性的预测因素
Comprehensive Positive Airway Pressure Titration Parameters as Predictors of Therapeutic Adherence in Obstructive Sleep Apnea.
文献信息
| PMID | 42795327 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jayoung Oh |
| 作者单位 | Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, 31, Soonchunhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea. |
| 期刊 | Life (Basel, Switzerland) |
| SCI 分区 | Q1 |
| IF | 3.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 气道正压（PAP）滴定期间的生理反应是否独立于基线严重程度预测依从性尚不清楚。
方法： 在2020年至2022年间于一家三级大学医院接受手动PAP滴定的304例患者中，依从性依据韩国报销标准定义（初始90天内任意连续30天期间，≥70%的夜晚每晚使用≥4小时）。滴定参数根据各自分布采用相应检验进行比较，并纳入经年龄、性别、体质指数和基线呼吸暂停低通气指数（AHI）校正的逻辑回归，采用自举法验证。
结果： 依从组（n = 238）与非依从组（n = 66）的基线严重程度相当。三个滴定参数存在差异：AHI下降率（p = 0.033）、最低血氧饱和度（SpO2；p = 0.010）和快速眼动睡眠比例（p = 0.021）。将这些参数加入仅含混杂因素的模型后，曲线下面积从0.566升至0.683（p < 0.001；乐观校正后为0.632）。仅校正混杂因素时，三者均显著，但相互校正后仅最低SpO2保持独立（比值比，每1%为1.117；95% CI，1.028-1.214）。
结论： 在PAP滴定期间记录的生理参数中，最低SpO2是短期依从性最稳健的预测因素，独立于基线疾病严重程度和基线低氧血症。需要前瞻性验证。
英文摘要
Background: Whether the physiological response during positive airway pressure (PAP) titration predicts adherence independently of baseline severity is unclear. Methods: In 304 patients who underwent manual PAP titration at a tertiary university hospital between 2020 and 2022, adherence was defined by Korean reimbursement criteria (≥4 h/night on ≥70% of nights within any consecutive 30-day period during the initial 90 days). Titration parameters were compared using tests appropriate to each distribution and entered into logistic regression adjusted for age, sex, body mass index and baseline apnea-hypopnea index (AHI), with bootstrap validation. Results: Adherent (n = 238) and non-adherent (n = 66) groups had comparable baseline severity. Three titration parameters differed: AHI reduction rate (p = 0.033), lowest oxygen saturation (SpO2; p = 0.010) and rapid eye movement-sleep proportion (p = 0.021). Adding these parameters to a confounder-only model raised the area under the curve from 0.566 to 0.683 (p < 0.001; optimism-corrected, 0.632). Adjusted for confounders alone, all three were significant, but with mutual adjustment only the lowest SpO2 remained independent (odds ratio, 1.117 per 1%; 95% CI, 1.028-1.214). Conclusions: Among the physiological parameters recorded during PAP titration, the lowest SpO2 was the most robust predictor of short-term adherence, independent of both baseline disease severity and baseline hypoxemia. Prospective validation is required.