Shih Chang-Chih, Wang Jen-Chun, Tsai Shih-Hung, Chung Chi-Hsiang, Chen Sy-Jou, Liao Wen-I, Tsao Chang-Huei, Wu Yung-Fu, Chien Wu-Chien
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
J Vasc Res. 2018;55(4):235-243. doi: 10.1159/000491928. Epub 2018 Aug 22.
To determine whether patients with obstructive sleep apnoea (OSA) have an increased risk of aortic aneurysm (AA).
The data for the nationwide population-based retrospective cohort study described here were obtained from the Taiwan National Health Insurance Research Database (NHIRD). We selected adult patients who had been newly diagnosed as having OSA and were followed up between 2000 and 2010. We excluded patients who had been diagnosed as having AA before the date of the new OSA diagnosis. The control cohort consisted of individuals who had no OSA history. The patients and the control cohort were selected by 1: 4 matching according to the following baseline variables: sex, age, index year, and comorbidities. The outcome measure was AA diagnosis.
In total, 31,274 patients diagnosed as having OSA were identified. Compared to patients without OSA, they had no significantly discrepant cumulative risk of developing AA in subsequent years (p from log-rank test = 0.442). We used the Cox proportional-hazards regression model, which found that only male sex, older age, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and coronary artery disease were independently associated with AA occurrence among subjects with an OSA diagnosis. OSA was not associated with AA development. On the other hand, in the subgroup of COPD, patients with OSA had a higher incidence of risk of AA than those without OSA.
When compared to those without OSA, patients with OSA do not have an increased AA risk.
确定阻塞性睡眠呼吸暂停（OSA）患者发生主动脉瘤（AA）的风险是否增加。
此处描述的基于全国人群的回顾性队列研究数据来自台湾国民健康保险研究数据库（NHIRD）。我们选择了新诊断为OSA并在2000年至2010年期间接受随访的成年患者。我们排除了在新的OSA诊断日期之前被诊断为患有AA的患者。对照组由无OSA病史的个体组成。根据以下基线变量按1:4匹配选择患者和对照组：性别、年龄、索引年份和合并症。结局指标为AA诊断。
共识别出31274例诊断为OSA的患者。与无OSA的患者相比，他们在随后几年发生AA的累积风险无显著差异（对数秩检验p = 0.442）。我们使用Cox比例风险回归模型，发现只有男性、老年、糖尿病、慢性阻塞性肺疾病（COPD）和冠状动脉疾病与OSA诊断患者中AA的发生独立相关。OSA与AA的发生无关。另一方面，在COPD亚组中，OSA患者发生AA的风险高于无OSA的患者。
与无OSA的患者相比，OSA患者发生AA的风险并未增加。
