摘要
本研究旨在探讨经鼻持续气道正压通气(CPAP)治疗的阻塞性睡眠呼吸暂停综合征(OSAS)患者死亡的危险因素和原因。对1985年1月1日至1993年12月31日以及1996年1月1日期间在国家呼吸障碍住所观察站(antdir)登记的患者数据进行单变量和多变量分析。与法国人口的存活率进行了比较。一项病例对照研究将死亡的患者与同年龄、同性别、同区域协会、同时配备CPAP的患者进行了比较。5669例患者接受了CPAP治疗。二百七十六年已经死了。124例死亡病例与123例对照组进行了对比。总体死亡率与法国总人口相同。死亡的独立危险因素是年龄、动脉血氧饱和度(Pa,O2)和一秒用力呼气量(FEV1)(预测百分比)。在病例-对照研究中,过去病史中死亡的独立危险因素为心律失常(OR) 2.8(95%可信区间(CI) 1.1-7.2)、呼吸障碍(OR 2.8; CI 1.6-4.9) ischaemic events (OR 2.2; CI 1.2-4.2), neurological and psychiatric disorders (OR 2.4; CI 1.1-5.4). A significant excess of cardiovascular deaths and an excess of deaths from accidents and poisonings was found. In conclusion, patients die on therapy predominantly from cardiovascular causes but many have a past history of cardiovascular conditions. Compliance with treatment may be important for survival. Continuous positive airway pressure is an effective therapy for obstructive sleep apnoea syndrome but older patients with reduced spirometry and hypoxaemia may need more attention paid to these aspects of their condition.