Am J Crit Care:睡眠呼吸暂停患者若白天嗜睡,心血管病风险明显升高

2019-02-21 XUJING 中国循环杂志

美国呼吸与危重病医学杂志在线公布的最新研究表明,患有阻塞性睡眠呼吸暂停(OSA)的成年人在白天出现过度嗜睡,其患心血管疾病的风险比那些没有过度白天嗜睡的人大得多。

美国呼吸与危重病医学杂志在线公布的最新研究表明,患有阻塞性睡眠呼吸暂停(OSA)的成年人在白天出现过度嗜睡,其患血管疾病的风险比那些没有过度白天嗜睡的人大得多。

研究者根据症状将中度到重度OSA患者可分为四种亚型:睡眠不安、症状轻微、中度嗜睡和重度嗜睡。

本研究分析了1207名参与睡眠心脏健康研究的成年人的数据。患者在入组时年龄在40岁及以上,随访近12年。患者患有中度至重度OSA,定义为睡眠时每小时至少有15次发作呼吸暂停或呼吸减弱(低通气)。

参与者报告了诸如入睡困难、打鼾、疲劳、昏昏欲睡和白天困倦等症状,并使用了一种广泛使用的问卷(称为Epworth困倦量表)来确定患者的亚型。

研究发现,表现出重度嗜睡的参与者患心力衰竭的可能性是其他三种亚型的3倍以上。

而且,重度嗜睡者随访期间发生血管事件(心脏病发作、心力衰竭、中风或心血管死亡)的可能性大约是其他三种亚型的两倍。

此外,只有过度嗜睡者的心血管疾病发病率高于无OSA的患者。

作者表示,与OSA相关的心血管疾病的风险增加似乎是由过度嗜睡亚型的OSA患者造成的。

研究人员认为,对持续气道正压通气(CPAP)治疗OSA的心血管益处的研究应该集中在过度嗜睡的亚型上,类患者很可能从CPAP治疗中获益最多。

临床医生应该认识到那些在白天醒来感到疲劳以及白天嗜睡的OSA患者患心血管疾病的风险更大。

原始出处:
Diego R Mazzotti, Brendan T Keenan, Diane C Lim, et al. Symptom Subtypes of Obstructive Sleep Apnea Predict Incidence of Cardiovascular Outcomes. American Journal of Respiratory and Critical Care Medicine. Feb 2019.

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    2019-02-28 1df0e68am86(暂无匿称)

    需要进一步证实

    0

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