Gao Li, Peng Yating, Ouyang Ruoyun
Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011.
Research Institute of Respiratory Diseases, Central South University, Changsha 410011.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Oct 28;49(10):1582-1590. doi: 10.11817/j.issn.1672-7347.2024.240252.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep-disordered breathing condition that exhibits a notable degree of heterogeneity, a feature not fully considered in current diagnostic and therapeutic strategies. This article reviews and analyzes research progress in the subtyping of OSAHS from multiple perspectives, including clinical feature-based subtyping, comorbidity-based subtyping, polysomnography (PSG) parameter-based subtyping, and other classification approaches. Existing studies have identified common subtypes based on clinical features and clarified the characteristics of different subgroups in comorbidity-based classifications; the rich data provided by PSG have helped optimize the classification of OSAHS; and multi-dimensional clustering has provided a more precise basis for individualized treatment. Although these studies have deepened the understanding of the heterogeneity of OSAHS, challenges such as significant differences among subtypes and insufficient evidence for alternative therapies remain. Future research should focus on identifying biomarkers and elucidating the underlying pathophysiological mechanisms to advance the development of precision treatments.
阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种常见的睡眠呼吸紊乱疾病,具有显著的异质性,而这一特征在当前的诊断和治疗策略中并未得到充分考虑。本文从多个角度综述并分析了OSAHS亚型分类的研究进展,包括基于临床特征的亚型分类、基于合并症的亚型分类、基于多导睡眠图(PSG)参数的亚型分类以及其他分类方法。现有研究已基于临床特征确定了常见亚型,并阐明了基于合并症分类中不同亚组的特征;PSG提供的丰富数据有助于优化OSAHS的分类;多维聚类为个体化治疗提供了更精确的依据。尽管这些研究加深了对OSAHS异质性的理解,但亚型之间存在显著差异以及替代疗法证据不足等挑战依然存在。未来的研究应聚焦于识别生物标志物并阐明潜在的病理生理机制,以推动精准治疗的发展。