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帕金森病中的阻塞性睡眠呼吸暂停:一种普遍存在、具有临床相关性且可治疗的特征。

Obstructive sleep apnea in Parkinson's disease: A prevalent, clinically relevant and treatable feature.

机构信息

Department of Cardiology, Wuhan Red Cross Hospital, 392 Hongkong Road, Wuhan, Hubei China; Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

出版信息

Parkinsonism Relat Disord. 2023 Oct;115:105790. doi: 10.1016/j.parkreldis.2023.105790. Epub 2023 Aug 1.

Abstract

Parkinson's disease (PD) is a chronic neurodegenerative disease characterized by motor and non-motor symptoms, including obstructive sleep apnea (OSA), a common comorbid sleep disorder. The prevalence of OSA in PD is high, and its impact on quality of life, accident risk, and limited treatment options underscores the need for vigilant monitoring and effective interventions. OSA is observed in 20-70% of PD patients, whereas the general population exhibits a lower prevalence ranging from 2 to 14%. These discrepancies in prevalence may be attributed to differences in demographic characteristics, sample sizes with selection bias, and variations in scoring systems for apnea and hypopnea events used across different studies. This review highlights the potential pathogenesis of comorbid OSA in PD and provides an overview of ongoing clinical trials investigating interventions for this condition. Several mechanisms have been implicated in the development of OSA in PD, including intermittent hypoxemia, sleep fragmentation, alterations in the glymphatic system homeostasis, upper airway obstruction, and inflammation. Given the adverse effects of PD comorbid OSA, early intervention measures are crucial. It is imperative to conduct longitudinal studies and clinical trials to elucidate the pathogenesis and develop novel and effective interventions for OSA in PD patients. These efforts aim to delay the progression of PD, enhance patients' quality of life, and alleviate the burden on society and families.

摘要

帕金森病(PD)是一种慢性神经退行性疾病,其特征为运动和非运动症状,包括阻塞性睡眠呼吸暂停(OSA),这是一种常见的合并睡眠障碍。PD 患者中 OSA 的患病率很高,其对生活质量、事故风险和有限的治疗选择的影响突显了对其进行警惕监测和有效干预的必要性。在 PD 患者中,OSA 的发生率为 20-70%,而普通人群的发生率较低,为 2-14%。这些患病率的差异可能归因于人口统计学特征、具有选择偏差的样本量、以及不同研究中用于呼吸暂停和低通气事件评分系统的差异。这篇综述强调了 PD 合并 OSA 的潜在发病机制,并概述了正在进行的针对这种情况的干预措施的临床试验。几种机制与 PD 中 OSA 的发生有关,包括间歇性低氧血症、睡眠片段化、糖质系统内稳态的改变、上气道阻塞和炎症。鉴于 PD 合并 OSA 的不良影响,早期干预措施至关重要。必须进行纵向研究和临床试验,以阐明发病机制,并为 PD 患者的 OSA 开发新的有效干预措施。这些努力旨在延缓 PD 的进展、提高患者的生活质量,并减轻社会和家庭的负担。

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