Lavie P, Herer P, Peled R, Berger I, Yoffe N, Zomer J, Rubin A H
Sleep Laboratory and Unit of Pulmonary Diseases, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
Sleep. 1995 Apr;18(3):149-57. doi: 10.1093/sleep/18.3.149.
During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored in the Technion sleep laboratories. Their age at the time of diagnosis ranged between 21 and 79 years. Fifty-seven patients (53 men and 4 women) had died by 1990, 53% due to respiratory-cardiovascular causes. The observed/expected (O/E) mortality rates, calculated for men only, revealed excess mortality of patients under 70 years old. Excess mortality was significant in the fourth and fifth decades (3.33, p < 0.002; 3.23, p < 0.0002, respectively). In patients older than 70 O/E was 0.33 (p < 0.0007). Hierarchical multivariate analysis with four fixed variables [age, body mass index (BMI), hypertension and apnea index] and four additional variables added manually one at a time (heart disease, lung disease, diabetes, apnea duration) was used to determine the predictors of death from all causes, cardiopulmonary causes and from myocardial infarction (MI). All four major variables were found to be significant predictors of mortality from all causes, in addition to lung disease and heart disease. Only age and BMI were significant predictors of cardiopulmonary deaths in addition to lung disease. Age, BMI and hypertension predicted MI deaths in addition to lung disease. These results were interpreted to suggest that SAS affects death indirectly, most probably by being a risk factor for hypertension.
1976年至1988年期间，我们在以色列理工学院睡眠实验室对1620名成年男女进行监测，诊断出睡眠呼吸暂停综合征（SAS）。他们确诊时的年龄在21岁至79岁之间。到1990年，已有57名患者（53名男性和4名女性）死亡，其中53%死于呼吸 - 心血管疾病。仅针对男性计算的观察/预期（O/E）死亡率显示，70岁以下患者存在超额死亡率。在第四和第五个十年中，超额死亡率显著（分别为3.33，p < 0.002；3.23，p < 0.0002）。70岁以上患者的O/E为0.33（p < 0.0007）。采用分层多变量分析，纳入四个固定变量[年龄、体重指数（BMI）、高血压和呼吸暂停指数]以及另外四个一次手动添加一个的变量（心脏病、肺病、糖尿病、呼吸暂停持续时间），以确定各种原因、心肺原因和心肌梗死（MI）导致死亡的预测因素。除了肺病和心脏病外，所有四个主要变量均被发现是各种原因导致死亡的显著预测因素。除了肺病外，只有年龄和BMI是心肺死亡的显著预测因素。除了肺病外，年龄、BMI和高血压可预测MI死亡。这些结果被解释为表明SAS可能通过成为高血压的危险因素而间接影响死亡。
