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持续气道正压通气治疗:对阻塞性睡眠呼吸暂停患者血脂的影响

Continuous positive airway pressure treatment: effect on serum lipids in patients with obstructive sleep apnoea.

作者信息

Michailidis Vassileios, Steiropoulos Paschalis, Nena Evangelia, Papanas Nikolaos, Maltezos Efstratios, Bouros Demosthenes

机构信息

Department of Pneumonology, Democritus University of Thrace, Greece.

出版信息

Open Cardiovasc Med J. 2011;5:231-8. doi: 10.2174/1874192401105010231. Epub 2011 Dec 26.

Abstract

Obstructive Sleep Apnoea (OSA) is a common disorder in adults. Its hallmark is repetitive episodes of partial or complete obstruction of the upper airway during sleep associated with increasing respiratory efforts. This leads to oxyhaemoglobin desaturation, sleep fragmentation, and daytime symptoms, mainly excessive sleepiness. Accumulating evidence suggests that intermittent hypoxia and oxyhaemoglobin desaturation may, irrespective of obesity, lead to elevation of serum lipids even in non-dyslipidaemic OSA patients. Continuous Positive Airway Pressure (CPAP) is the treatment of choice for OSA, since it eliminates upper airway collapse during sleep and improves sleep fragmentation, daytime symptoms and quality of life. Moreover, it has been proposed that the amelioration of breathing disturbances during sleep can improve several markers of the lipid profile, such as total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol as well as apolipoproteins A, B and C. Indeed, some studies have reported improvements in these parameters especially in CPAP adherent patients. However, other studies failed to confirm this beneficial effect. The present article reviews the issue whether CPAP treatment exerts a beneficial effect on lipids.

摘要

阻塞性睡眠呼吸暂停(OSA)是成年人中的一种常见病症。其标志是睡眠期间上呼吸道反复出现部分或完全阻塞,并伴有呼吸努力增加。这会导致氧合血红蛋白饱和度下降、睡眠片段化以及日间症状,主要是过度嗜睡。越来越多的证据表明,即使在非血脂异常的OSA患者中,间歇性缺氧和氧合血红蛋白饱和度下降也可能导致血脂升高,而与肥胖无关。持续气道正压通气(CPAP)是OSA的首选治疗方法,因为它可消除睡眠期间上呼吸道塌陷,并改善睡眠片段化、日间症状和生活质量。此外,有人提出改善睡眠期间的呼吸紊乱可改善血脂谱的几个指标,如总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇以及载脂蛋白A、B和C。事实上,一些研究报告了这些参数的改善,尤其是在坚持使用CPAP的患者中。然而,其他研究未能证实这种有益效果。本文综述了CPAP治疗是否对血脂有有益作用这一问题。

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