在患有阻塞性睡眠呼吸暂停的老年患者中,抑郁症与长期心血管风险的关联
Zhe Zhao1, Yinghui Gao2, Junling Lin3
1Cardiology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China.
Nature and science of sleep
|December 11, 2023
概括
抑郁症显著增加了阻塞性睡眠呼吸暂停 (OSA) 的老年人主要不良心血管事件 (MACE) 的风险. 在OSA患者中早期发现和治疗抑郁症对于心血管健康至关重要.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 精神病学是一个精神病学.
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是心血管疾病 (CVD) 的已知危险因素.
- 在患有OSA的患者中经常观察到抑郁症,可能会加剧心血管疾病风险.
- 抑郁症对老年OSA患者心血管结果的预后影响需要进一步调查.
研究的目的:
- 评估OSA诊断的老年人中抑郁症对主要不良心血管事件 (MACE) 的预测价值.
- 为了确定抑郁症是否独立地影响这个人群中MACE的发病率.
主要方法:
- 一项前性研究涉及1106名患有OSA的老年患者,不包括之前有重大心脏事件的患者.
- 多睡眠图 (PSG) 和老年抑郁度量表 (GDS-12) 用于诊断和评估.
- 考克斯比例危险分析被用来评估MACE的风险,抑郁症被定义为GDS-12得分>3和OSA作为呼吸暂停-呼吸暂停指数 (AHI) >5.
主要成果:
- 在研究队列中,12.0%的人患有抑郁症,8.7%的人患有MACE.
- 抑郁症与MACE的累积发病率较高显著相关.
- 多变量分析证实,抑郁症独立地增加了MACE风险 (aHR = 2.29; P = 0.002),特别是在男性,超重/肥胖个体和中度至重度OSA患者中.
结论:
- 抑郁症是老年OSA患者中普遍存在的疾病,以前没有发生过重大心脏事件.
- 抑郁症的存在使MACE的风险独立且显著增加.
- 这些发现强调了查和管理OSA老年人抑郁症的重要性,以减轻心血管风险.
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