Sampol Gabriel, Romero Odile, Salas Armando, Tovar José L, Lloberes Patricia, Sagalés Teresa, Evangelista Arturo
Respiratory Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Am J Respir Crit Care Med. 2003 Dec 15;168(12):1528-31. doi: 10.1164/rccm.200304-566OC. Epub 2003 Aug 6.
Obstructive sleep apnea syndrome (OSAS) is a process that is associated with the development of arterial hypertension, the main risk factor for aortic dissection and during obstructive episodes of the upper airways with marked increases in transmural pressure of the aorta wall. The aim of this work was to study the association between aortic dissection and OSAS. Nineteen consecutive patients with thoracic aorta dissection and 19 hypertensive patients of similar age, sex, and body mass index were studied by clinical questionnaire and polysomnography. Snoring and nonrefreshing sleep were common in both groups. Thirteen patients (68%) from each group showed an apnea-hypopnea index of more than 5 per hour. However, patients with aortic dissection presented a higher apnea-hypopnea index (28 [30.3] versus 11.1 [10.4], p=0.032). Seven patients with dissection presented an apnea-hypopnea index of more than 30 versus 1 patient in the control group (p=0.042). Patients with thoracic aorta dissection presented a high prevalence of previously undiagnosed and frequently severe OSAS. Further studies, including this diagnosis as a prognostic variable in the follow-up of patients with aortic dissection, are required. Our results suggest that in patients with aortic dissection and symptoms consistent with OSAS, a sleep study should be considered in their clinical management.
阻塞性睡眠呼吸暂停综合征（OSAS）是一个与动脉高血压发展相关的过程，动脉高血压是主动脉夹层的主要危险因素，且在上气道阻塞发作期间，主动脉壁的跨壁压会显著升高。这项研究的目的是探讨主动脉夹层与OSAS之间的关联。通过临床问卷和多导睡眠图对19例连续性胸主动脉夹层患者以及19例年龄、性别和体重指数相近的高血压患者进行了研究。两组患者中打鼾和睡眠质量不佳的情况都很常见。每组中有13例患者（68%）的呼吸暂停低通气指数超过每小时5次。然而，主动脉夹层患者的呼吸暂停低通气指数更高（28 [30.3] 对比11.1 [10.4]，p = 0.032）。7例夹层患者的呼吸暂停低通气指数超过30，而对照组中只有1例（p = 0.042）。胸主动脉夹层患者中先前未被诊断出且常为重度的OSAS患病率较高。需要进一步开展研究，将这一诊断作为主动脉夹层患者随访中的一个预后变量。我们的研究结果表明，对于有主动脉夹层且有与OSAS相符症状的患者，在其临床管理中应考虑进行睡眠研究。
