Chest:睡眠呼吸紊乱与皮肤黑色素瘤的侵袭性增加相关

2018-07-29 xing.T MedSci原创

由此可见,SDB的严重程度与皮肤黑色素瘤的侵袭性独立相关,尤其是在年轻患者中。

睡眠呼吸紊乱(SDB)与癌症的发病率和死亡率增加有关,尽管这些研究结果并不一致。然而,目前没有大型研究在特定类型癌症患者中分析这种关联。近日,呼吸领域权威杂志chest上发表了一篇研究文章,该研究旨在评估SDB严重程度与皮肤黑色素瘤侵袭性标志之间潜在的关联。

研究人员对443名确诊为黑色素瘤6个月内的患者进行了睡眠研究,收集了一般人口统计学指标、黑色素瘤特征以及包含呼吸暂停-低通气指数(AHI)、连续和间歇性夜间氧合血红蛋白去饱和指数(DI4%)在内的多指标参数。研究人员探究了SDB与各种黑素瘤侵袭性客观标志(Breslow指数、有无溃疡、有无消退、有丝分裂指数、严重程度、前哨淋巴损伤和黑素瘤扩散)之间的独立关系。

在调整年龄、性别、肿瘤位置和体重指数后,研究人员发现AHI或DI4%处于较高三分位数的患者与处于最低三分位数的患者相比,存在侵袭性黑色素瘤(Breslow指数>1mm)的几率分别增加1.94(95%置信区间[CI]:1.14-3.32,p=0.022)和1.93(95%CI:1.14-3.26,p=0.013)倍。这种关联在Breslow指数>2mm的不超过56岁的患者中尤为突出。其他侵略性标志的存在也与较高的AHI和DI4%值相关。

由此可见,SDB的严重程度与皮肤黑色素瘤的侵袭性独立相关,尤其是在年轻患者中。

原始出处:

M.A. Martinez-Garcia,et al. Sleep-Disordered Breathing is Independently Associated with Increased Aggressiveness of Cutaneous Melanoma. A multicentre observational study in 443 patients.chest.2018. https://journal.chestnet.org/article/S0012-3692(18)31109-7/fulltext

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createdName=Smile2680, createdTime=Wed Apr 24 18:55:00 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989093, encodeId=21871989093ce, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Nov 13 23:55:00 CST 2018, time=2018-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680545, encodeId=c88a168054539, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Tue Jun 11 10:55:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=336232, encodeId=38333362324f, content=睡眠质量非常重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Aug 04 08:49:54 CST 2018, time=2018-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335825, encodeId=f4133358251e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c53c2405614, createdName=汪海波, createdTime=Thu Aug 02 18:58:56 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366313, encodeId=0b221366313a0, content=<a href='/topic/show?id=186126998e2' target=_blank style='color:#2F92EE;'>#侵袭性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26998, encryptionId=186126998e2, topicName=侵袭性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436008, encodeId=8a061436008eb, content=<a href='/topic/show?id=c38de2137e4' target=_blank style='color:#2F92EE;'>#皮肤黑色素瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72137, encryptionId=c38de2137e4, topicName=皮肤黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558915, encodeId=e30e155891521, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564924, encodeId=fc5515649241c, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=)]
    2019-06-11 sunylz
  5. [GetPortalCommentsPageByObjectIdResponse(id=2051191, encodeId=f9e02051191a7, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Jul 04 01:55:00 CST 2019, time=2019-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929504, encodeId=3c71192950481, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c53c2405614, createdName=汪海波, createdTime=Thu Aug 02 18:58:56 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366313, encodeId=0b221366313a0, content=<a href='/topic/show?id=186126998e2' target=_blank style='color:#2F92EE;'>#侵袭性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26998, encryptionId=186126998e2, topicName=侵袭性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436008, encodeId=8a061436008eb, content=<a href='/topic/show?id=c38de2137e4' target=_blank style='color:#2F92EE;'>#皮肤黑色素瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72137, encryptionId=c38de2137e4, topicName=皮肤黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558915, encodeId=e30e155891521, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564924, encodeId=fc5515649241c, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=)]
    2018-08-04 易水河

    睡眠质量非常重要

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2051191, encodeId=f9e02051191a7, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Jul 04 01:55:00 CST 2019, time=2019-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929504, encodeId=3c71192950481, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, 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encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Tue Jun 11 10:55:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=336232, encodeId=38333362324f, content=睡眠质量非常重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Aug 04 08:49:54 CST 2018, time=2018-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335825, encodeId=f4133358251e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c53c2405614, createdName=汪海波, createdTime=Thu Aug 02 18:58:56 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366313, encodeId=0b221366313a0, content=<a href='/topic/show?id=186126998e2' target=_blank style='color:#2F92EE;'>#侵袭性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26998, encryptionId=186126998e2, topicName=侵袭性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436008, encodeId=8a061436008eb, content=<a href='/topic/show?id=c38de2137e4' target=_blank style='color:#2F92EE;'>#皮肤黑色素瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72137, encryptionId=c38de2137e4, topicName=皮肤黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558915, encodeId=e30e155891521, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564924, encodeId=fc5515649241c, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=)]
    2018-08-02 汪海波

    学习

    0

  7. 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c53c2405614, createdName=汪海波, createdTime=Thu Aug 02 18:58:56 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366313, encodeId=0b221366313a0, content=<a href='/topic/show?id=186126998e2' target=_blank style='color:#2F92EE;'>#侵袭性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26998, encryptionId=186126998e2, topicName=侵袭性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436008, encodeId=8a061436008eb, content=<a href='/topic/show?id=c38de2137e4' target=_blank style='color:#2F92EE;'>#皮肤黑色素瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, 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GetPortalCommentsPageByObjectIdResponse(id=1564924, encodeId=fc5515649241c, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Tue Jul 31 09:55:00 CST 2018, time=2018-07-31, status=1, ipAttribution=)]
    2018-07-31 sunyl07
  8. 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  9. 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  10. 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睡眠障碍性呼吸(SDB)是独立存在的心血管疾病风险因素,从过去的流行病学研究来看,男性SDB或阻塞性睡眠呼吸暂停(OSA)的发病率高于女性,但女性在绝经后的发病率显著增加。与快速眼动(REM)睡眠相关的SDB是指:在REM睡眠期间,主要出现睡眠呼吸暂停和呼吸浅慢的现象。用睡眠呼吸暂停低通气指数(AHI)来定义,REM和非REM的比率(R:N)高于2.0。 OSA患者更容易出现SD

EHJ:入院新诊断的睡眠呼吸暂停与急性心衰患者出院后死亡独立相关

心力衰竭(简称心衰)的睡眠障碍性呼吸(SDB)常见,1月30日在线发表于《欧洲心脏杂志》(Eur Heart J)的一项研究对睡眠障碍性呼吸和心衰患者出院后死亡率的关系进行了探讨,结果表明,在急性心衰(AHF)住院期间,新诊断的中枢型睡眠呼吸暂停综合征(CSA)和阻塞性睡眠呼吸暂停(OSA)与患者出院后死亡独立相关。研究者表示,这是至今为止评估SDB对AHF患者出院后死亡影响的最大型研究。

Neurology:睡眠呼吸紊乱增加民众卒中风险

美国约5000-7000万名成年人存在不同程度的睡眠障碍,这为他们增加某些健康风险。埃森大学医院的Dirk M.Hermann和同事指出,既往研究已经表明睡眠障碍与卒中的形成和预后有关。为了更好地了解这之间的关联,研究人员进行了一项荟萃分析研究,以评估睡眠障碍如失眠、阻塞性睡眠呼吸暂停(OSA)与卒中和预后之间的关系。2343名发生过缺血性卒中、出血性卒中或短暂性脑缺血发作(TIA)的患者参与研究