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甲状腺功能减退与阻塞性睡眠呼吸暂停的关联。

Association of hypothyroidism and obstructive sleep apnea.

作者信息

Kapur V K, Koepsell T D, deMaine J, Hert R, Sandblom R E, Psaty B M

机构信息

University of Washington, Seattle; and Group Health Cooperative of Puget Sound, Redmond, Washington, USA.

出版信息

Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1379-83. doi: 10.1164/ajrccm.158.5.9712069.

Abstract

Obstructive sleep apnea (OSA) and hypothyroidism are relatively common disorders that have similar clinical features and are thought to be causally linked. We sought to determine the prevalence of previously unrecognized hypothyroidism in a series of patients evaluated for OSA and whether an association between hypothyroidism and OSA was present. Chart review was used to obtain information on thyroid function status, polysomnography results, levothyroxine use, and clinical signs and symptoms in 336 consecutive adult patients who underwent polysomnography for suspected OSA. In addition, levothyroxine use was determined in age- and sex-matched control subjects for the purposes of a case-control study. Among the patients without prior history of hypothyroidism who underwent polysomnography and thyroid function testing, four new cases or 1. 41% (95% CI 0.04-2.78) were found to have subclinical hypothyroidism. Our findings do not support routine thyroid screening by specialists in patients referred for polysomnography. The odds ratio of the association of prior history of hypothyroidism to OSA was 1. 47 (95% CI 0.8-2.8). Limitations in study design may have limited our ability to detect a statistically significant association between OSA and hypothyroidism.

摘要

阻塞性睡眠呼吸暂停(OSA)和甲状腺功能减退是相对常见的疾病,它们具有相似的临床特征,并且被认为存在因果联系。我们试图确定在一系列因OSA接受评估的患者中既往未被识别的甲状腺功能减退的患病率,以及甲状腺功能减退与OSA之间是否存在关联。通过查阅病历,获取了336例因疑似OSA接受多导睡眠监测的成年患者的甲状腺功能状态、多导睡眠监测结果、左甲状腺素使用情况以及临床症状和体征等信息。此外,为了进行病例对照研究,还确定了年龄和性别匹配的对照受试者的左甲状腺素使用情况。在接受多导睡眠监测和甲状腺功能检测且无甲状腺功能减退既往史的患者中,发现4例新的亚临床甲状腺功能减退病例,患病率为1.41%(95%CI 0.04 - 2.78)。我们的研究结果不支持多导睡眠监测转诊患者由专科医生进行常规甲状腺筛查。甲状腺功能减退既往史与OSA关联的优势比为1.47(95%CI 0.8 - 2.8)。研究设计的局限性可能限制了我们检测OSA与甲状腺功能减退之间统计学显著关联的能力。

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