阻塞性睡眠呼吸暂停和心脏突然死亡的风险:系统性审查和元分析
Xiaorong Zou1, Xiong Zhou1, Song Yi2
1Yichun People's Hospital, Yichun, Jiangxi, 336000, China.
BMC cardiovascular disorders
|October 22, 2025
概括
证据不足以将阻塞性睡眠呼吸暂停 (OSA) 与突然心脏死亡 (SCD) 联系起来. 未经治疗的OSA可能会带来风险,但由于研究的局限性,总体发现是不确定的.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 公共卫生 公共卫生
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与心血管问题有关,但其与突然心脏死亡 (SCD) 的直接联系需要进一步调查.
- 现有研究提出了关于OSA作为SCD的独立风险因素的相互矛盾的证据.
研究的目的:
- 系统地审查和元分析评估OSA和SCD之间的关联的观察性研究.
- 评估通过呼吸暂停-呼吸暂停指数 (AHI) 表示的OSA严重程度是否影响SCD的风险.
- 为了确定持续正气道压力 (CPAP) 处理对OSA-SCD关系的影响.
主要方法:
- 在主要数据库 (PubMed,Scopus,Web of Science,Google Scholar) 进行了全面的文献搜索,截至2025年1月.
- 包括的研究是观察性的,报告了OSA和SCD发病率.
- 使用随机效应模型汇总数据,对AHI严重程度和CPAP使用进行子组分析;还分析了调整后的几率比率 (aOR).
主要成果:
- 分析了12项涉及50多万参与者的研究.
- 在OSA患者中,SCD的整体聚合几率比率在统计学上并不显著 (OR = 1.41,p=0.12),具有很高的异质性.
- 未经治疗的OSA显示显著增加风险 (OR = 3.87,p=0.04),但在CPAP治疗中没有观察到这种情况;调整后的分析也缺乏意义 (aOR = 0.90,p=0.10).
结论:
- 目前的证据不足以确定OSA作为SCD的风险因素.
- 虽然未经治疗的OSA可能与增加SCD风险有关,但总体发现受到显著的异质性和研究设计的限制.
- 需要进一步进行高质量的研究,以澄清OSA,其治疗和SCD风险之间的复杂关系.
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