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[阻塞性睡眠呼吸暂停与心血管疾病——一项回顾性研究]

[Obstructive sleep apnoea and cardiovascular disease--a retrospective study].

作者信息

Drummond Marta, Winck J C, Pereira S, Almeida J, Marques J A

机构信息

Serviço de Pneumologia do Hospital de São João.

出版信息

Rev Port Pneumol. 2003 Jul-Aug;9(4):327-35. doi: 10.1016/s0873-2159(15)30684-x.

Abstract

INTRODUCTION

Obstructive Sleep Apnea (OSA) is associated with adverse effects in cardiovascular physiology. Some studies have connected this pathology with Cardiovascular Disease (CVD).

AIM

Determine the prevalence of CVD in patients with OSA of different severity and verify the association between CVD and OSA.

MATERIAL AND METHODS

Retrospective study based on data from 155 consecutive patients with OSA referred to a Sleep Disordered Breathing Clinic in an University Hospital during the year of 2001.

RESULTS

The majority of patients were male (83,2%), the mean age was 53,6 +/- 11,9 years. Severe OSA was observed in 52,9% patients, moderate in 20% and mild in 27,1% patients (mean Apnea Hypopnea Index of 35,2 +/- 23,8/hour). Among the studied individuals 52,3% showed CVD, being Arterial Hypertension (AH) the most common disease (45,8%). Acute Myocardial Infarction appeared in 6,5% and Angina in 3,9% cases. The majority of the patients (67,1%) were obese (Body Mass Index - BMI>30). The mean BMI was 33,1 +/- 6,34. A significant (31%) number of patients reported Lipid Disorders and 11% reported Diabetes mellitus. The majority (51,3%) of patients referred smoking habits. Severity of OSA (evaluated by AHI) was significantly higher in women with AH (p= 0,033) and significantly lower in patients who developed Cerebrovascular Disease (CeVD) (p = 0,036).

CONCLUSIONS

The studied population presented a high prevalence of CVD, being the severity of OSA significantly higher in women with AH. The increased prevalence of CVD in patients with OSA has been documented in recent epidemiologic studies. The physiopathologic mechanisms underlying this association, certainly, deserve further investigation.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)与心血管生理的不良影响相关。一些研究已将这种病理情况与心血管疾病(CVD)联系起来。

目的

确定不同严重程度的OSA患者中CVD的患病率,并验证CVD与OSA之间的关联。

材料与方法

基于2001年期间转诊至某大学医院睡眠呼吸障碍诊所的155例连续性OSA患者的数据进行回顾性研究。

结果

大多数患者为男性(83.2%),平均年龄为53.6±11.9岁。52.9%的患者存在重度OSA,20%为中度,27.1%为轻度(平均呼吸暂停低通气指数为35.2±23.8次/小时)。在研究对象中,52.3%表现出CVD,其中动脉高血压(AH)最为常见(45.8%)。急性心肌梗死出现率为6.5%,心绞痛为3.9%。大多数患者(67.1%)肥胖(体重指数 - BMI>30)。平均BMI为33.1±6.34。相当数量(31%)的患者报告有血脂异常,11%报告有糖尿病。大多数(51.3%)患者有吸烟习惯。患有AH的女性中OSA的严重程度(通过AHI评估)显著更高(p = 0.033),而发生脑血管疾病(CeVD)患者的OSA严重程度显著更低(p = 0.036)。

结论

研究人群中CVD患病率较高,患有AH的女性中OSA严重程度显著更高。近期流行病学研究已证实OSA患者中CVD患病率增加。这种关联背后的病理生理机制当然值得进一步研究。

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