快速眼动期呼吸暂停对阻塞性睡眠呼吸暂停患者外周动脉僵硬度的不同影响。

Different effects of apnea during rapid eye movement period on peripheral arterial stiffness in obstructive sleep apnea.

机构信息

Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Sleep Medicine Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Adapted Physical Education, National Taiwan Sport University, Taoyuan, Taiwan.

出版信息

Atherosclerosis. 2018 Feb;269:166-171. doi: 10.1016/j.atherosclerosis.2018.01.008. Epub 2018 Jan 12.

DOI:10.1016/j.atherosclerosis.2018.01.008

PMID:29366989

Abstract

BAKGROUND AND AIMS

Obstructive sleep apnea (OSA) contributes to cardiovascular diseases, including arterial stiffness. The association between OSA and peripheral arterial stiffness indices remains controversial.

METHODS

This study recruited 275 patients who were referred for sleep apnea study. Arterial stiffness was assessed by peripheral compliance index (CI) and central pulse wave velocity derived from digital volume pulse (PWV) by photoplethysmography. Overnight polysomnography and autonomic nerve system function tests were also conducted.

RESULTS

A total of 275 patients (170 men) were recruited. Most were middle-aged and overweight. Most patients (112/275, 40.7%) had rapid eye movement (REM)-predominant OSA. The CI was significantly correlated with the apnea-hypopnea index (AHI) (R = -0.132, p = 0.029) and AHI-REM (R = -0.170, p = 0.005) and AHI non-REM (R = -0.122, p = 0.043). Among models and variable used to predict CI, only male sex (B = -0.708, p = 0.007) and AHI-REM (B = -0.010, p = 0.033) were independent predictors of CI. An increase in the interquartile range of AHI-REM was associated with a 9.6% decrease in CI.

CONCLUSIONS

AHI-REM was independently correlated with a peripheral arterial stiffness index, CI. AHI-REM may be a suitable surrogate marker for predicting peripheral arterial stiffness in OSA patients.

摘要

背景与目的

阻塞性睡眠呼吸暂停（OSA）可导致心血管疾病，包括动脉僵硬。OSA 与外周动脉僵硬指数之间的关联仍存在争议。

方法

本研究招募了 275 名因睡眠呼吸暂停而接受检查的患者。通过光体积描记法的外周顺应性指数（CI）和中央脉搏波速度（由数字体积脉搏衍生而来的 PWV）评估动脉僵硬。还进行了整夜多导睡眠图和自主神经系统功能测试。

结果

共招募了 275 名患者（170 名男性）。大多数患者年龄在中年左右，体重超重。大多数患者（275 例中的 112 例，40.7%）患有快速眼动（REM）为主的 OSA。CI 与呼吸暂停低通气指数（AHI）（R= -0.132，p=0.029）和 AHI-REM（R= -0.170，p=0.005）以及 AHI 非 REM（R= -0.122，p=0.043）显著相关。在用于预测 CI 的模型和变量中，只有男性（B= -0.708，p=0.007）和 AHI-REM（B= -0.010，p=0.033）是 CI 的独立预测因素。AHI-REM 增加一个四分位间距与 CI 降低 9.6%相关。