Stroke:睡眠呼吸暂停与亚临床颈动脉粥样硬化之间的关系

2019-10-15 xing.T MedSci原创

在这个大型的多民族人群样本中,睡眠障碍与男性和女性亚临床颈动脉粥样硬化相关,尤其是那些<68岁的个体。SA与颈动脉粥样硬化之间关联的潜在机制可能因颈动脉斑块和颈内膜中膜厚度而异。

睡眠呼吸暂停(SA)的许多健康效应可能是由动脉粥样硬化加速引起的。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在一个大型的多种族人群样本中评估打呼噜和SA的几种测量指标与亚临床颈动脉粥样硬化之间的相关性。

该分析纳入了来自动脉粥样硬化的多民族研究(MESA)(2010-2013年)第5次检查的1615名参与者(平均年龄68岁)。睡眠指标包括来自完整的家庭多导睡眠图的SA(呼吸暂停-低通气指数[4%],≥15次事件/小时)。研究人员使用高分辨率B超测量颈动脉粥样硬化。多元线性和逻辑回归模型分别用于评估睡眠暴露与颈动脉内膜中层厚度和颈动脉斑块之间的关系。研究人员根据年龄、性别和种族/民族划分评估了效果修改。 

在多变量分析中,年龄<68岁的个体SA与颈动脉斑块存在几率增加相关(比值比为1.47;95%CI为1.05-2.06),但在老年个体中则不然(比值比为0.95;95%CI为0.67-1.37;相互作用P=0.078)。较严重的低氧血症(睡眠时间饱和度<90%)与年轻参与者(0.028±0.014mm)的颈动脉内膜中层厚度增加有关,而与老年人(-0.001±0.013mm;相互作用 P=0.106)无关。自我报告的打呼噜与颈动脉粥样硬化无关。在评估种族特异性结局时,较严重的低氧血症与黑人颈动脉内膜中层厚度增加有关(0.049±0.017 mm;相互作用P=0.033)。

在这个大型的多民族人群样本中,睡眠障碍与男性和女性亚临床颈动脉粥样硬化相关,尤其是那些<68岁的个体。SA与颈动脉粥样硬化之间关联的潜在机制可能因颈动脉斑块和颈内膜中膜厚度而异。 

原始出处:

Ying Y. Zhao.et al.Associations Between Sleep Apnea and Subclinical Carotid Atherosclerosis The Multi-Ethnic Study of Atherosclerosis.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.022184

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1843558, encodeId=a1ed1843558d6, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Sun Nov 03 09:48:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989134, encodeId=c2f31989134b7, 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=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Apr 20 07:48:00 CST 2020, time=2020-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1944620, encodeId=c1d9194462069, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Sun Nov 17 13:48:00 CST 2019, time=2019-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459375, encodeId=e85c14593e534, content=<a href='/topic/show?id=477610056158' target=_blank style='color:#2F92EE;'>#颈动脉粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100561, encryptionId=477610056158, topicName=颈动脉粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88db6138923, createdName=经常头晕, createdTime=Thu Oct 17 10:48:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596578, encodeId=55f615965e88b, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, 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=Thu Oct 17 10:48:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050237, encodeId=ac22105023eb3, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Oct 15 22:48:00 CST 2019, time=2019-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373957, encodeId=d0593e39576c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Tue Oct 15 20:02:23 CST 2019, time=2019-10-15, status=1, ipAttribution=)]
    2019-10-15 jingjing

    大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等

    0

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    2019-10-15 一个字-牛

    学习了谢谢分享

    0

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由此可见,在未治疗的严重OSA的老年患者中,卒中发生率而非冠心病发病率有所增加。适当的CPAP治疗可以降低这种风险。

Am J Respir Crit Care:新方法可有效治疗睡眠呼吸困难

美国科学家日前进行的一项研究显示,一种广为人知的可调节饥饿和体重的激素,可通过鼻腔给药的方式缓解睡眠过程中出现的呼吸问题。