阻塞性睡眠呼吸暂停及其心血管后果
T Douglas Bradley1, John S Floras
1Sleep Research Laboratory of the Toronto Rehabilitation Institute, Toronto, Canada.
Lancet (London, England)
|December 23, 2008
概括
阻塞性睡眠呼吸暂停 (OSA) 显著影响心血管健康,增加患高血压和心力衰竭等疾病的风险. 治疗OSA可能会降低这些风险,但需要进行大规模试验来确认改善心血管结果.
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) 涉及睡眠期间重复停止呼吸.
- 这些事件导致缺氧,阴性胸内压力和唤醒,压力心血管系统.
- OSA与高血压,冠状动脉疾病,心力衰竭和中风的风险增加有关.
研究的目的:
- 审查阻塞性睡眠呼吸暂停的心血管影响.
- 评估治疗OSA对心血管健康的潜在益处.
- 确定是否需要进一步的大规模临床试验.
主要方法:
- 对OSA和心血管疾病的流行病学研究的审查.
- 来自随机试验的数据分析,调查OSA的持续正气道压力 (CPAP) 治疗.
- 综合目前关于将OSA与心血管事件联系起来的病理生理机制的证据.
主要成果:
- OSA会触发有害的心血管刺激,包括缺氧,交感激活和炎症.
- 在心力衰竭患者中,CPAP治疗已显示出降低血压和改善心脏功能等好处.
- 流行病学数据强烈地将OSA与主要心血管疾病联系在一起.
结论:
- 阻塞性睡眠呼吸暂停是心血管疾病的重要危险因素.
- 治疗OSA,特别是使用CPAP,在减轻心血管风险方面表现有前途.
- 进一步的大规模随机试验至关重要,以最终确定OSA治疗是否改善心血管结果.
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