阻塞性睡眠呼吸暂停:对心脏和血管疾病的影响
Abu S M Shamsuzzaman1, Bernard J Gersh, Virend K Somers
1Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
JAMA
|October 9, 2003
概括
阻塞性睡眠呼吸暂停 (OSA) 是常见的,并与心血管疾病的进展有关. 早期诊断和治疗OSA对于管理心脏病和改善患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 内部医学 内部医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 越来越被认为是心血管疾病发展和恶化的重要因素.
- OSA的患病率很大,大约有20%的成年人患有轻度OSA,15%患有中度OSA.
研究的目的:
- 进行科学文献的系统审查,检查OSA与心血管病理生理学和疾病之间的复杂关系.
- 综合当前关于OSA如何影响心血管损伤和疾病进展背后的机制的知识.
主要方法:
- 在MEDLINE数据库 (1966-2003) 中进行了全面的搜索,使用与睡眠,睡眠呼吸暂停和各种心血管疾病相关的关键词进行了搜索.
- 优先纳入的研究是大型前性队列研究和随机对照试验,以确保有力的证据.
- 从154个已识别的调查和审查中提取和分析数据,以确定它们与研究目标的相关性.
主要成果:
- 在OSA中,重复性呼吸暂停事件会破坏正常的心血管睡眠相互作用,导致睡眠碎片化.
- OSA与生理异常有关,包括同情激活增加,内皮功能障碍,氧化应激,炎症和代谢失调.
- 证据强烈表明,OSA有助于高血压,心脏缺血,心力衰竭,心律失常和潜在的中风.
结论:
- 阻塞性睡眠呼吸暂停是一种流行,可诊断和可治疗的疾病,通常与心血管疾病并存.
- OSA激活了已知会导致心脏和血管损伤的病理生理路径,这可能会阻碍治疗的有效性.
- 虽然正在等待大规模试验数据,但对于心血管疾病患者,建议对OSA诊断和治疗益处进行个性化评估.
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