Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Clin Exp Rheumatol. 2019 Nov-Dec;37 Suppl 121(6):132-136. Epub 2019 Dec 9.
Superior vena cava syndrome (SVCS) is a medical emergency which can also be seen in Behçet's syndrome (BS). Having noted that BS patients with SVCS frequently complained of sleep disturbances, snoring and sleep apnea, suggesting obstructive sleep apnea (OSA), we formally surveyed the risk for OSA among BS patients.
We studied 28 patients, all male, with SVCS (Group 1), 129 with vascular involvement without a SVCS (Group 2) and 151 with no vascular involvement (Group 3). In addition, 100 apparently healthy individuals (Group 4) were studied. The Berlin questionnaire (BQ), a validated screening tool with a high sensitivity and modest specificity that identifies individuals with high-risk for OSA, was administered to all study participants.
The study groups were similar with regard to age (Group 1, mean age: 44.3±9.7; Group 2, mean age: 41.5±8.7, Group 3, mean age: 40.4±9.4 and Group 4, mean age: 42.1±9.4) mean body mass index and the frequency of hypertension and other comorbidities. The frequency of those patients at high-risk for OSA according to the BQ was 57%, 17%, 17% and 11% in Groups 1, 2, 3 and 4, respectively (p<0.05). Age-adjusted ORs of OSA compared to healthy controls (Group 4) was 11.00 (95%CI: 4.01-30.07) for Group 1, 1.78 (95%CI: 0.81-3.94) for Group 2, 1.92 (95%CI: 0.90-4.14) for Group 3.
BS patients with SVCS are at high risk for OSA. This is probably due to the external pressure of the significant presence of venous collaterals that surround the upper airways. Our results should be further confirmed by polysomnography, and future research should be carried out to clarify the causes of this association.
上腔静脉综合征（SVCS）是一种医学急症，也可见于白塞病（BS）患者。我们注意到，BS 伴 SVCS 患者常抱怨睡眠障碍、打鼾和睡眠呼吸暂停，提示阻塞性睡眠呼吸暂停（OSA），因此我们正式调查了 BS 患者发生 OSA 的风险。
我们研究了 28 例 SVCS 患者（第 1 组）、129 例无 SVCS 但有血管受累的患者（第 2 组）和 151 例无血管受累的患者（第 3 组），所有患者均为男性。此外，还研究了 100 名健康个体（第 4 组）。所有研究对象均接受了柏林问卷（BQ）的评估，这是一种具有高敏感性和适度特异性的有效筛查工具，可识别 OSA 高危个体。
各组在年龄（第 1 组，平均年龄：44.3±9.7；第 2 组，平均年龄：41.5±8.7；第 3 组，平均年龄：40.4±9.4；第 4 组，平均年龄：42.1±9.4）、平均体重指数、高血压和其他合并症的频率方面相似。根据 BQ，第 1、2、3 和 4 组中高危 OSA 的患者频率分别为 57%、17%、17%和 11%（p<0.05）。与健康对照组（第 4 组）相比，OSA 的年龄校正 OR 分别为第 1 组 11.00（95%CI：4.01-30.07）、第 2 组 1.78（95%CI：0.81-3.94）、第 3 组 1.92（95%CI：0.90-4.14）。
BS 伴 SVCS 患者存在发生 OSA 的高风险。这可能是由于上气道周围存在大量静脉侧支循环导致的外部压力所致。我们的结果应通过多导睡眠图进一步证实，未来的研究应进一步阐明这种关联的原因。
