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阻塞性睡眠呼吸暂停对胸主动脉和肺动脉的影响:CT 评估。

Effects of obstructive sleep apnea on the thoracic aorta and the main pulmonary artery: assessment by CT.

机构信息

Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.

Institute of Clinical Physiology, National Research Council, Pisa, Italy.

出版信息

J Clin Sleep Med. 2021 Jan 1;17(1):3-11. doi: 10.5664/jcsm.8770.

Abstract

STUDY OBJECTIVES

The influence of obstructive sleep apnea (OSA) on thoracic aortic size is debated. We aimed to identify possible relations between sleep parameters and the sizes of the ascending aorta (AA), the descending thoracic aorta (DTA), and the main pulmonary artery (MPA) in patients with untreated OSA and in a subgroup of participants without comorbidities capable of affecting the size of great thoracic vessels.

METHODS

We retrospectively measured AA, DTA, and MPA sizes on the chest computed tomography scans of 60 patients with OSA who underwent sleep studies within 1 year before or after the computed tomography. Univariate and multivariate analyses were performed on all patient findings, while an additional univariate analysis was conducted on the data for 22 participants without comorbidities. The latter had been divided into subgroups depending on the sleep parameters, and comparisons were made between them.

RESULTS

The logarithm of the time of oxygen saturation below 90% (CT90) significantly predicted AA and MPA sizes in all patients with OSA (P < .05). Oxygen desaturation index and minimum oxygen saturation were moderately correlated with AA and DTA sizes in patients without comorbidities (P < .01). In this group, subjects with oxygen desaturation index > 30 or minimum oxygen saturation < 81% had greater AA and DTA dimensions (P < .05).

CONCLUSIONS

In patients with OSA, time of oxygen saturation < 90% influenced AA and MPA sizes. In those patients without comorbidities, oxygen desaturation index and minimum oxygen saturation were moderately correlated with both AA and DTA sizes. Participants without comorbidities with oxygen desaturation index > 30 or minimum oxygen saturation < 81% had greater AA and DTA dimensions.

摘要

研究目的

阻塞性睡眠呼吸暂停(OSA)对胸主动脉大小的影响存在争议。我们旨在确定未治疗的 OSA 患者以及无可能影响大血管大小的合并症的亚组参与者的睡眠参数与升主动脉(AA)、降胸主动脉(DTA)和主肺动脉(MPA)大小之间可能存在的关系。

方法

我们回顾性地测量了 60 例 OSA 患者的胸部 CT 扫描中的 AA、DTA 和 MPA 大小,这些患者在 CT 扫描前或后 1 年内进行了睡眠研究。对所有患者的发现进行了单变量和多变量分析,同时对无合并症的 22 名参与者的数据进行了额外的单变量分析。后者根据睡眠参数分为亚组,并对它们进行了比较。

结果

氧饱和度低于 90%的时间(CT90)的对数在所有 OSA 患者中均显著预测 AA 和 MPA 大小(P <.05)。氧减饱和指数和最低氧饱和度与无合并症患者的 AA 和 DTA 大小中度相关(P <.01)。在该组中,氧减饱和指数> 30 或最低氧饱和度< 81%的患者的 AA 和 DTA 尺寸更大(P <.05)。

结论

在 OSA 患者中,氧饱和度< 90%的时间影响 AA 和 MPA 大小。在无合并症的患者中,氧减饱和指数和最低氧饱和度与 AA 和 DTA 大小中度相关。氧减饱和指数> 30 或最低氧饱和度< 81%的无合并症参与者的 AA 和 DTA 尺寸更大。

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