CPAP治疗对阻塞性睡眠低通气综合征患者导管消融术后心房颤动复发率影响的Meta分析

杜国栋; 吕云辉; 雷强; 马磊; 相艳; 孙睿; 邵党国; 苗志斌

doi:10.13201/j.issn.1001-1439.2017.05.005

CPAP治疗对阻塞性睡眠低通气综合征患者导管消融术后心房颤动复发率影响的Meta分析

- 1. 昆明理工大学信息工程与自动化学院(昆明, 650500);
- 2. 云南省第一人民医院呼吸科
基金项目:
国家自然科学基金资助项目（No：61163021）

详细信息

通讯作者: 马磊,E-mail:roy_murray@qq.com

中图分类号: R541.7

收稿日期: 2016-11-24

Effects of CPAP treatment on AF recurrence in patients with obstructive sleep hypopnea syndrome after catheter ablation: A Meta analysis

- 1. Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, 650500, China;
- 2. Respiratory Medicine, First People's Hospital of Yunnan Province

More Information

Corresponding author: MA Lei, E-mail: roy_murray@qq.com

Received Date: 24 November 2016

摘要

摘要: 目的：系统评价持续气道正压通气（CPAP）对阻塞性睡眠低通气综合征（OSA）患者经导管消融术后心房颤动（AF）复发率的影响。方法：计算机检索PubMed、MEDILINE、EMBASE、Cochrane library、知网、万方等数据库，检索时限从建库到2016年10月。严格按照纳入和排除标准筛选文献并提取数据，评价纳入研究的质量后，采用Stata 14软件进行Meta分析。结果：共纳入6篇队列研究，共计1 044例OSA合并AF患者。Meta分析结果显示：CPAP治疗后OSA患者导管消融术后AF的复发率显著低于对照组（RR=0.68，95%CI：0.58~0.79，I²=0，P=0.911）。结论：CPAP治疗可有效降低OSA患者导管消融术后AF的复发率，提示临床医生在诊治OSA合并AF患者过程中可以考虑使用CPAP进行治疗。
- 持续气道正压通气 /
- 阻塞性睡眠呼吸暂停低通气综合征 /
- 心房颤动 /
- 导管消融术
Abstract: Objective: To systematically evaluate the effect of continuous positive airway pressure(CPAP) on atrial fibrillation (AF) recurrence rate in patients with obstructive sleep hypopnea syndrome (OSA) after catheter ablation. Method: The database was retrieved from PubMed, Medline, EMBASE, Cochrane, library, CNKI and Wanfang from inception to October, 2016. The literature was screened in strict accordance with inclusion and exclusion criteria. Stata14 software was used for Meta analysis. Result: Six cohort studies involving 1 044 patients with OSA combined with AF were included. Meta analysis results showed that the recurrence rate of AF after CPAP treatment was significantly lower than that in control group (RR=0.68, 95%CI:0.58-0.79, I²=0, P=0.911). Conclusion: CPAP can effectively reduce the recurrence rate of AF after catheter ablation in patients with OSA.
- continuous positive airway pressure /
- obstructive sleep apnea hypopnea syndrome /
- atrial fibrillation /
- catheter ablation

HTML全文

参考文献(13)

[1]	LAM J C, MAK J C, IP M S. Obesity, obstructive sleep apnoea and metabolic syndrome[J]. Respirology, 2012, 17:223-236.
[2]	NARUSE Y, TADA H, SATOH M, et al. Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation:Clinical impact of continuous positive airway pressure therapy[J]. Heart Rhythm, 2013, 10:331-337.
[3]	JONGNARANGSIN K, CHUGH A, GOOD E, et al. Body mass index, obstructive sleep apnea, and outcomes of catheter ablation of atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2008, 19:668-672.
[4]	PATEL D, MOHANTY P, BIASE L D, et al. Safety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea:the impact of continuous positive airway pressure[J]. Circ Arrhythm Electrophysiol, 2010, 3:445-451.
[5]	FEIN A S, SHVILKIN A, SHAH D, et al. Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation[J]. J Am Coll Cardiol, 2013, 62:300-305.
[6]	NEILAN T G, FARHAD H, DODSON J A, et al. Effect of sleep apnea and continuous positive airway pressure on cardiac structure and recurrence of atrial fibrillation[J]. J Am Heart Assoc, 2013, 2:e000421-e000421.
[7]	朱小芳, 李良海. 持续正压通气联合导管消融术治疗阻塞性睡眠呼吸暂停综合征伴阵发性房颤患者的疗效观察[J]. 内科急危重症杂志, 2014, 20(4):264-265.
[8]	邓婷智, 尹微, 欧柏青. 血管紧张素Ⅱ受体拮抗剂抗心房颤动的研究进展[J]. 临床心血管病杂志, 2010, 26(1):4-6.
[9]	SCHNABEL R B, YIN X, GONA P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study:a cohort study[J]. Lancet, 2015, 386:154-162.
[10]	MCEVOY R D, ANTIC N A, HEELEY E, et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.[J]. New Engl J Med, 2016, 375:919-931.
[11]	LI L, WANG Z, LI J, et al. Efficacy of catheter ablation of atrial fibrillation in patients with obstructive sleep apnoea with and without continuous positive airway pressure treatment:A meta-analysis of observational studies[J]. Europace, 2014, 16:1309-1314.
[12]	SHUKLA A, AIZER A, HOLMES D, et al. Effect of obstructive sleep apnea treatment on atrial fibrillation recurrence:A Meta-analysis[J]. JACC Clin Electrophysiol, 2015, 1:41-51.
[13]	KANAGALA R, NARAYANA S M, FRIEDMAN P A. Obstructive sleep apnea and the recurrence of atrial fibrillation[J]. Circulation, 2003, 107:2589-2594.