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阻塞性睡眠呼吸暂停对中风后并发症的影响:一项系统评价和荟萃分析。

The Influence of Obstructive Sleep Apnea on Post-Stroke Complications: A Systematic Review and Meta-Analysis.

作者信息

Kurra Nithin, Gandrakota Nikhila, Ramakrishnan Manju, Sudireddy Kavya, Boorle Naga Vijaya Lakshmi Divya, Jillella Dinesh

机构信息

Department of Neurology, University of Nebraska Medical Center, Omaha, NE 68198, USA.

Department of Family & Preventive Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.

出版信息

J Clin Med. 2024 Sep 23;13(18):5646. doi: 10.3390/jcm13185646.

Abstract

Evidence shows that obstructive sleep apnea (OSA) is associated with the development of stroke. This study investigates the relationship between OSA and post-stroke complications, addressing the limited data on how OSA influences the severity and development of these complications through a systematic review of existing literature. Data was collected from PubMed, Web of Science, and Scopus databases up to December 2023. Studies meeting the inclusion criteria were selected, and statistical analyses were performed using Review Manager 5.4.1. A random-effects model was used for pooling data with heterogeneity, and findings were presented using standard ratios with 95% confidence intervals. The analysis included nine studies. Stroke patients with OSA did not show a significantly higher risk of post-stroke complications, which include mild cognitive impairment, dementia, insomnia, fatigue, reduced sleep quality, depression, anxiety, recurrent strokes, and death, compared with those without OSA (RR = 1.05, 95% CI 0.97 to 1.13). However, patients with high stroke severity and OSA had a slightly higher risk of post-stroke complications (RR = 1.06, 95% CI 1.01 to 1.12). This systematic review and meta-analysis suggests that OSA confers a higher risk of post-stroke complications in patients with high stroke severity. Further studies are required to explore the impact of OSA on post-stroke complications.

摘要

有证据表明,阻塞性睡眠呼吸暂停(OSA)与中风的发生有关。本研究调查了OSA与中风后并发症之间的关系,通过对现有文献的系统回顾,探讨OSA如何影响这些并发症的严重程度和发展情况,目前这方面的数据有限。截至2023年12月,从PubMed、科学网和Scopus数据库收集数据。选择符合纳入标准的研究,并使用Review Manager 5.4.1进行统计分析。采用随机效应模型对具有异质性的数据进行汇总,并使用95%置信区间的标准比值呈现研究结果。该分析纳入了9项研究。与没有OSA的中风患者相比,患有OSA的中风患者发生中风后并发症的风险没有显著更高,这些并发症包括轻度认知障碍、痴呆、失眠、疲劳、睡眠质量下降、抑郁、焦虑、复发性中风和死亡(RR = 1.05,95% CI 0.97至1.13)。然而,中风严重程度高且患有OSA的患者发生中风后并发症的风险略高(RR = 1.06,95% CI 1.01至1.12)。这项系统评价和荟萃分析表明,OSA使中风严重程度高的患者发生中风后并发症的风险更高。需要进一步的研究来探讨OSA对中风后并发症的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179d/11433435/d20a0be673e3/jcm-13-05646-g001.jpg

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