Peromaa-Haavisto P, Tuomilehto H, Kössi J, Virtanen J, Luostarinen M, Pihlajamäki J, Käkelä P, Victorzon M
Hatanpää City Hospital, Department of Surgery, Tampere, Finland.
Oivauni Sleep Clinic, Kuopio, Finland; Oivauni Sleep Clinic, Tampere, Finland; Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Finland.
Sleep Med. 2017 Jul;35:85-90. doi: 10.1016/j.sleep.2016.12.017. Epub 2017 Jan 12.
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder, particularly in bariatric patients. It is known to be tightly linked with metabolic abnormalities and cardiovascular morbidity. Obesity is the most noteworthy individual risk factor for OSA. The aim of this study was to investigate the effect of a laparoscopic Roux-en-Y gastric bypass (LRYGB) on OSA one year after surgery.
In this prospective multicenter study standard overnight cardiorespiratory recording was conducted 12 months after bariatric surgery in 132 patients who had OSA in the baseline recording prior to the operation. The main outcome measures were changes in the prevalence of OSA and apnea-hypopnea index (AHI). In addition, the changes in anthropometric and demographic measurements including weight, body mass index (BMI), and waist and neck circumference were evaluated. A sleep symptom questionnaire was administered at baseline and at 12 months.
The prevalence of OSA decreased from 71% at baseline to 44% at 12 months after surgery (p < 0.001). OSA was cured in 45% and cured or improved in 78% of the patients, but moderate or severe OSA still persisted in 20% of the patients after the operation. De novo OSA occurred in eight percent of the patients, and total AHI decreased from 27.8 events/h to 9.9 events/h (p < 0.001).
LRYGB is effective in treating OSA. However, the findings demonstrate that a postoperative cardiorespiratory recording is needed in order to identify the patients with persistent moderate to severe OSA after the operation.
ClinalTrials.gov; No.: NCT01080404; URL: www.clinicaltrials.gov.
阻塞性睡眠呼吸暂停（OSA）是一种高度流行的睡眠障碍，在肥胖症患者中尤为常见。已知它与代谢异常和心血管疾病密切相关。肥胖是OSA最值得注意的个体危险因素。本研究的目的是调查腹腔镜Roux-en-Y胃旁路术（LRYGB）术后一年对OSA的影响。
在这项前瞻性多中心研究中，对132例在手术前基线记录中患有OSA的患者进行了减肥手术后12个月的标准夜间心肺记录。主要结局指标是OSA患病率和呼吸暂停低通气指数（AHI）的变化。此外，还评估了人体测量和人口统计学测量的变化，包括体重、体重指数（BMI）以及腰围和颈围。在基线和12个月时进行了睡眠症状问卷调查。
OSA患病率从基线时的71%降至术后12个月时的44%（p<0.001）。45%的患者OSA得到治愈，78%的患者治愈或改善，但术后仍有20%的患者存在中度或重度OSA。8%的患者出现新发OSA，总AHI从27.8次/小时降至9.9次/小时（p<0.001）。
LRYGB对治疗OSA有效。然而，研究结果表明，术后需要进行心肺记录，以识别术后仍存在中度至重度OSA的患者。
ClinicalTrials.gov；编号：NCT01080404；网址：www.clinicaltrials.gov。
