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在阻塞性呼吸暂停中使用CPAP和视网膜疾病风险:一组研究

Dillan Cunha Amaral¹, Pedro Lucas Machado Magalhães², Muhammad Alfatih³

¹Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-853, RJ, Brazil.

Vision (Basel, Switzerland)

|August 22, 2025

概括

在患有阻塞性睡眠呼吸暂停 (OSA) 的成年人中,持续的正气压 (CPAP) 治疗可能会降低糖尿病视网膜病变和与年龄相关的黄斑退化风险. 需要进一步的研究来证实这些发现.

科学领域:

眼科眼科
睡眠医学
心血管研究

背景情况:

阻塞性睡眠呼吸暂停 (OSA) 与全身炎症和血管功能障碍有关,导致视网膜疾病.
像OSA中间歇性缺氧这样的机制与各种视网膜疾病的发病有关.

研究的目的:

评估持续正气道压力 (CPAP) 疗法的有效性,以减少OSA成年人视网膜疾病的发生率.
评估CPAP对糖尿病视网膜病变 (DR),与年龄相关的黄斑变性 (AMD),视网膜静脉封闭 (RVO) 和中枢血清性视网膜病变 (CSC) 的影响.

主要方法:

使用TriNetX研究网络进行的回顾性队列研究.
在1:1倾向性比分匹配后,分析了101,754名OSA成年患者,BMI为25. 030. 0kg/ m2.
在接受CPAP治疗和未接受CPAP治疗的患者中,对DR,AMD,RVO和CSC的发生率进行了比较.

主要成果:

使用CPAP与糖尿病视网膜病变 (DR) (3.2%对3. 4%) 和与年龄相关的黄斑变性 (AMD) (2.1%对2. 3%) 的发生率有统计学意义的降低有关.
视网膜静脉封闭 (RVO) 或中央血清静脉病变 (CSC) 的发生率在两组之间没有显著差异.
对DR和AMD的相对风险降低分别为0. 922 (p=0. 016) 和0. 906 (p=0. 018).

结论:

在患有OSA的成年人中,CPAP治疗对特定的视网膜并发症,特别是DR和AMD具有潜在的保护作用.
这些发现支持现有证据,将CPAP与视网膜微血管健康的改善联系起来.
需要进一步的前性研究来证实这些结果,考虑到CPAP的坚持和OSA的严重程度等因素.

关键词:

用CPAP治疗糖尿病视网膜病变阻塞性睡眠呼吸暂停视网膜疾病

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