阻塞性睡眠呼吸暂停低通气综合征与心血管疾病相关性研究的新进展  

New Progress in Study of Correlation between Obstructive Sleep Apnea Hypopnea Syndrome and Cardiovascular Disease

作　　者：杨东[1] 许轶[1] 曹晖 周慧芳[1] YANG Dong;XU Yi;CAO Hui;ZHOU Huifang(Department of Otolaryngology,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院耳鼻喉科,天津300052

出　　处：《医学综述》2022年第22期4497-4502,共6页Medical Recapitulate

摘　　要：阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者可反复出现低氧血症及高碳酸血症,血管内皮结构紊乱和功能障碍在OSAHS发生发展及心血管并发症中起重要作用。高血压、冠心病、心力衰竭、肺动脉高压和心律失常伴发OSAHS,而且多数OSAHS患者同时存在肥胖、高血压、高血脂、代谢综合征等高危因素,这些因素可导致心血管疾病的发生。患者睡眠期间出现间歇性低氧血症、高碳酸血症、交感神经兴奋、活性氧生成增加,促进氧化应激反应,导致机体产生炎症反应和氧化应激水平升高、血管内皮生长因子增加、血管内皮紊乱功能下降、血管损伤。同时,活性氧和氧化应激又促进白细胞、血小板等在血管内膜上的募集和累积,损伤内皮细胞。在临床诊疗中,对心血管的状态评估和对血管损伤的早期预防与干预尤为重要。Patients with obstructive sleep apnea hypopnea syndrome(OSAHS)suffer from repeated hypoxemia and hypercapnia.Vascular endothelial structure disorder and dysfunction caused by OSAHS play an important role in the occurrence and development of diseases and cardiovascular complications in the patients.Hypertension,coronary heart disease,heart failure,pulmonary hypertension and arrhythmia are often associated with OSAHS,and most OSAHS patients also have high risk cardiovascular factors such as obesity,hypertension,hyperlipidemia and metabolic syndrome,which will further lead to the occurrence of cardiovascular diseases.During sleep,the patients have intermittent hypoxemia,hypercapnia,sympathetic nerve excitation,and increased production of reactive oxygen species,which promote oxidative stress reaction,leading to inflammatory reaction,increased oxidative stress level,increased vascular endothelial growth factor,vascular endothelial dysfunction,and vascular injury.Meanwhile,reactive oxygen species and oxidative stress promote the recruitment and accumulation of white blood cells and platelets,damaging the endothelial cells.In the clinical diagnosis and treatment,it is particularly important to assess the cardiovascular status and implement early prevention and intervention of vascular injury.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 心血管损伤 

分 类 号：R765[医药卫生—耳鼻咽喉科]