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阻塞性睡眠呼吸暂停与视神经病变的关联:一项基于台湾人群的队列研究。

Association between obstructive sleep apnea and optic neuropathy: a Taiwanese population-based cohort study.

机构信息

Department of Ophthalmology, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan.

Department of Ophthalmology, Stanford University, Stanford, CA, USA.

出版信息

Eye (Lond). 2018 Aug;32(8):1353-1358. doi: 10.1038/s41433-018-0088-1. Epub 2018 Apr 26.

Abstract

PURPOSE

Obstructive sleep apnea (OSA) is associated with many systemic diseases including diabetes, hypertension, stroke, and cardiovascular disease. The aim of our study was to investigate the association between OSA and optic neuropathy (ON), and to evaluate the efficacy of treatment for OSA on the risk of ON.

METHODS

We used the data from the Longitudinal Health Insurance Database, which involved one million insurants from Taiwan National Health Insurance program (Taiwan NHI).

RESULTS

OSA patients had a 1.95-fold higher risk of ON compared with non-OSA patients in all age group. The risk was significantly higher (adjusted hazard ratio: 4.21) in the group aged <45 years and male individuals (adjusted hazard ratio: 1.93). Meanwhile, sleep apnea was associated with ON regardless of the existence of comorbidity or not. OSA patients treated with continuous positive airway pressure (CPAP) had an adjusted 2.31-fold higher hazard of developing ON compared to controls, and those without any treatment had an adjusted 1.82-fold higher hazard of developing ON compared to controls. Moreover, ON patients had a 1.45-fold higher risk of OSA, and those aged between 45 and 64 years (hazard ratio: 1.76) and male individuals (hazard ratio: 1.55) had highest risk.

CONCLUSIONS

Our study showed that OSA increased the risk of developing ON after controlling the comorbidities; however, treatment with CPAP did not reduce the risk of ON. Further large population study accessing to medical records about the severity of OSA and treatment for OSA is needed to clarify the efficacy of treatment for OSA in reducing the risk of ON.

摘要

目的

阻塞性睡眠呼吸暂停(OSA)与许多系统性疾病有关,包括糖尿病、高血压、中风和心血管疾病。本研究旨在探讨 OSA 与视神经病变(ON)的关系,并评估 OSA 治疗对 ON 风险的疗效。

方法

我们使用了来自台湾全民健康保险计划(台湾 NHI)的 100 万被保险人的纵向健康保险数据库的数据。

结果

在所有年龄段的患者中,OSA 患者发生 ON 的风险比非 OSA 患者高 1.95 倍。在<45 岁和男性患者中,风险更高(调整后的危险比:4.21)。同时,无论是否存在合并症,睡眠呼吸暂停与 ON 有关。与对照组相比,接受持续气道正压通气(CPAP)治疗的 OSA 患者发生 ON 的调整后危险比为 2.31 倍,而未接受任何治疗的 OSA 患者发生 ON 的调整后危险比为 1.82 倍。此外,ON 患者发生 OSA 的风险增加了 1.45 倍,年龄在 45-64 岁之间(危险比:1.76)和男性(危险比:1.55)的患者风险最高。

结论

本研究表明,在控制合并症后,OSA 会增加发生 ON 的风险;然而,CPAP 治疗并不能降低 ON 的风险。需要进一步进行大型人群研究,获取有关 OSA 严重程度和 OSA 治疗的医疗记录,以阐明 OSA 治疗降低 ON 风险的疗效。

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