Stroke:伴有或不伴阻塞性睡眠呼吸暂停的肥胖患者减肥手术后房颤和卒中风险

2021-04-22 MedSci原创 MedSci原创

在接受腹腔镜可调胃束带减肥手术的肥胖患者中,尽管体重减轻程度相近,但OSA患者的AF和卒中发生率高于无OSA的患者。非AF和AF相关因素均与卒中风险增加有关。

肥胖患者的体重减轻可降低心房颤动(AF)的发生率;然而,尚不清楚阻塞性睡眠呼吸暂停(OSA)患者是否能获得类似的益处。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员试图明确减肥后OSA是否会影响AF和卒中的发生率,并确定AF和卒中的预测因素。

研究人员探究了腹腔镜可调胃束带减肥手术对房颤和卒中事件的影响在伴有和不伴有OSA患者整体和倾向匹配人群中的差异,并明确AF和卒中的独立预测因素。

827例接受腹腔镜可调胃束带减肥术的肥胖患者(平均年龄为44±11岁;平均体重指数为49±8 kg/m2)在平均6.0±3.2年的随访中,4.96%的患者发生AF,5.44%的患者发生卒中。尽管体重减轻的程度相似(3年内分别下降了19.6% vs. 21%),但整体(2.10% vs. 0.47%/年;P<0.001)和倾向性匹配队列中OSA患者的新发AF显著高于无OSA的患者。OSA患者的卒中发生率高于非OSA患者,但是只有20%的卒中伴有AF。在多因素分析中,OSA(风险比为2.88 [95%CI为1.45-5.73])、年龄和高血压是新发房颤和OSA(风险比为5.84 [95%CI为3.02-11.3.30])的独立预测因素。

由此可见,在接受腹腔镜可调胃束带减肥手术的肥胖患者中,尽管体重减轻程度相近,但OSA患者的AF和卒中发生率高于无OSA的患者。非AF和AF相关因素均与卒中风险增加有关。有必要对OSA治疗是否有助于降低该人群AF或卒中事件开展进一步调查。

原始出处:

Ahmed Dalmar.et al.Risk of Atrial Fibrillation and Stroke After Bariatric Surgery in Patients With Morbid Obesity With or Without Obstructive Sleep Apnea.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.031920

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    2021-09-13 tomyang96
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content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
  5. 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Sat Apr 24 01:03:21 CST 2021, time=2021-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959389, encodeId=26f0959389df, content=osa增加房颤 卒中分险, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220709/a510c1d082a042b5b7d85344c7f8539a/000346081d9f44ca9473cfda715d2eea.jpg, createdBy=5eec5483989, createdName=十八线开外美少女, createdTime=Thu Apr 22 14:23:18 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026824, encodeId=16181026824f5, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
  6. 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content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
  7. 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Sat Apr 24 01:03:21 CST 2021, time=2021-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959389, encodeId=26f0959389df, content=osa增加房颤 卒中分险, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220709/a510c1d082a042b5b7d85344c7f8539a/000346081d9f44ca9473cfda715d2eea.jpg, createdBy=5eec5483989, createdName=十八线开外美少女, createdTime=Thu Apr 22 14:23:18 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026824, encodeId=16181026824f5, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
    2021-04-22 十八线开外美少女

    osa增加房颤 卒中分险

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2066842, encodeId=d8de206684260, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Fri Jun 25 13:03:21 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989173, encodeId=fa8319891e3ee, 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=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Sat Apr 24 01:03:21 CST 2021, time=2021-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959389, encodeId=26f0959389df, content=osa增加房颤 卒中分险, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220709/a510c1d082a042b5b7d85344c7f8539a/000346081d9f44ca9473cfda715d2eea.jpg, createdBy=5eec5483989, createdName=十八线开外美少女, createdTime=Thu Apr 22 14:23:18 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026824, encodeId=16181026824f5, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
    2021-04-22 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2066842, encodeId=d8de206684260, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Fri Jun 25 13:03:21 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989173, encodeId=fa8319891e3ee, 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=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Sat Apr 24 01:03:21 CST 2021, time=2021-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959389, encodeId=26f0959389df, content=osa增加房颤 卒中分险, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220709/a510c1d082a042b5b7d85344c7f8539a/000346081d9f44ca9473cfda715d2eea.jpg, createdBy=5eec5483989, createdName=十八线开外美少女, createdTime=Thu Apr 22 14:23:18 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026824, encodeId=16181026824f5, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
    2021-04-22 心介

    房颤,临床上碰到很多哦

    0

  10. 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createdBy=3138208, createdName=zhanfl, createdTime=Sun Apr 25 09:03:21 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696972, encodeId=2f5b16969e2a2, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Mon Sep 13 00:03:21 CST 2021, time=2021-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1951033, encodeId=96651951033ba, content=<a href='/topic/show?id=72078190803' target=_blank style='color:#2F92EE;'>#肥胖患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Sat Apr 24 01:03:21 CST 2021, time=2021-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959389, encodeId=26f0959389df, content=osa增加房颤 卒中分险, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220709/a510c1d082a042b5b7d85344c7f8539a/000346081d9f44ca9473cfda715d2eea.jpg, createdBy=5eec5483989, createdName=十八线开外美少女, createdTime=Thu Apr 22 14:23:18 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026824, encodeId=16181026824f5, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031378, encodeId=254710313e843, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046046, encodeId=39cd1046046e8, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Apr 22 13:03:21 CST 2021, time=2021-04-22, status=1, ipAttribution=)]
    2021-04-22 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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