Kiernan Terri-Ellen J, Capampangan Dan J, Hickey Mark G, Pearce Lesly A, Aguilar Maria I
Mayo Clinic Arizona, Phoenix, AZ 85054, USA.
Neurologist. 2011 Sep;17(5):289-91. doi: 10.1097/NRL.0b013e31821a25d6.
Obstructive sleep apnea (OSA) is associated with hypertension (HTN) and cardiovascular disease. Transient episodes of hypoxia, hypercapnia, and blood pressure elevation during OSA may lead to neural damage and subsequently white matter disease (WMD). As WMD is usually the result of chronic small vessel ischemia, a relationship between OSA and cerebrovascular disease may exist. This case series aimed to establish a relationship between OSA and WMD. Sixty-two patients without cerebrovascular disease who had both a polysomnogram and brain magnetic resonance imaging were identified. All patients carried the diagnosis of HTN. WMD was evaluated using the age-related white matter changes scale. Although half of the study population had WMD on magnetic resonance imaging, no association was found between WMD with severity of OSA (P=0.9). Our results are limited by the small sample size and by coexistent HTN in all patients. Further studies are needed to elucidate the relationship between OSA and WMD, especially among nonhypertensive patients. Future research should also address if OSA treatment has any effect on WMD.
阻塞性睡眠呼吸暂停（OSA）与高血压（HTN）及心血管疾病相关。OSA期间的缺氧、高碳酸血症和血压升高的短暂发作可能导致神经损伤，进而引发白质病变（WMD）。由于WMD通常是慢性小血管缺血的结果，OSA与脑血管疾病之间可能存在关联。本病例系列旨在确立OSA与WMD之间的关系。确定了62例既进行了多导睡眠图检查又进行了脑磁共振成像检查且无脑血管疾病的患者。所有患者均被诊断为高血压。使用年龄相关白质变化量表评估WMD。尽管研究人群中有一半在磁共振成像上显示有WMD，但未发现WMD与OSA严重程度之间存在关联（P = 0.9）。我们的研究结果受到样本量小以及所有患者均存在高血压的限制。需要进一步研究以阐明OSA与WMD之间的关系，尤其是在非高血压患者中。未来的研究还应探讨OSA治疗对WMD是否有任何影响。
