阻塞性睡眠呼吸暂停与颈动脉粥样硬化关联性的横断面研究  

Cross Sectional Study on Relationship Between Obstructive Sleep Apnea and Carotid Arteriosclerosis

作　　者：杨占奇 张克 王宏宇[1,2] 范常锋 YANG Zhanqi;ZHANG Ke;WANG Hongyu;FAN Changfeng(Department of Vascular Medicine,Peking University Shougang Hospital,Beijing 100144,China;Vascular Health Research Center of Peking University Health Science Center(VHRC-PKUHSC),Beijing 100144,China;Pulmonary and Critical Medicine,Peking University Shougang Hospital,Beijing 100144,China;Geriatric Medicine,Peking Uinversity Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院血管医学中心,北京100144 [2]北京大学医学部血管健康研究中心,北京100144 [3]北京大学首钢医院呼吸与危重症医学科,北京100144 [4]北京大学首钢医院老年医学科,北京100144

出　　处：《心血管病学进展》2023年第12期1135-1141,共7页Advances in Cardiovascular Diseases

基　　金：北京大学首钢医院科研与发展基金(SSYYQ2021-2024)。

摘　　要：目的动脉粥样硬化性疾病已成为威胁人类生命健康的一大病种。既往有研究表明阻塞性睡眠呼吸暂停是动脉粥样硬化的危险因素之一,但存在争议。现探究未治疗的阻塞性睡眠呼吸暂停与颈动脉粥样硬化的关系。方法入组北京大学首钢医院睡眠呼吸科门诊2021年9月—2023年4月就诊的876例患者,并进行基线评估。选择多导睡眠监测作为睡眠呼吸暂停的检测手段,选择颈动脉超声作为颈动脉粥样硬化的检测手段。根据病历信息采集患者基线资料,组间对比采用t/χ^(2)检验,多因素变量采用logistic分析。结果在基线资料中,收集可能与动脉粥样硬化相关的传统危险因素。将多导睡眠监测值睡眠呼吸暂停低通气指数(AHI)与传统危险因素分别纳入logistic分析,在未调整的模型中,AHI与颈动脉粥样硬化存在统计学关系(男:95%CI 1.042~3.674,P<0.001;女:95%CI 1.077~4.032,P<0.001)。在对背景因素进行调整后,发现AHI与颈动脉粥样硬化仍存在统计学关系(男:95%CI 1.021~3.352,P<0.05;女:95%CI 1.021~4.045,P<0.05)。结论AHI与颈动脉粥样硬化存在统计学相关性。在对背景因素进行调整后,这种统计学关系依然存在。由此可推断未治疗的阻塞性睡眠呼吸暂停是颈动脉粥样硬化的危险因素。Objective Atherosclerosis has become a major disease that threatens people’s life and health.Obstructive sleep apnea is a possible risk factor for cardiovascular and cerebrovascular events.But there is a dispute.The purpose of this study was to investigate the relationship between untreated obstructive sleep apnea and carotid atherosclerosis.Methods A total of 876 patients in the sleep-breathing clinic of Beijing Shougang Hospital from September 2021 to April 2023 were included and evaluated at baseline.Polysomnography was selected as the detection method of sleep apnea,and carotid ultrasound was selected as the detection method of carotid atherosclerosis.The baseline data of patients were collected according to the medical record information.The t/χ^(2) test was used for comparison between groups,and the multivariate variables were analyzed by logistic logic.Results In baseline data,traditional risk factors that may be associated with atherosclerosis were collected.The polysomnography monitoring value apnea hypopnea index(AHI)and traditional risk factors were included in the logistic analysis.In the unadjusted model,there was a statistical relationship between AHI value and carotid atherosclerosis(male:95%CI 1.042~3.674,P<0.001;female:95%CI 1.077~4.032,P<0.001).After adjusting for background factors,it was found that there was still a statistical relationship between AHI and carotid atherosclerosis(male:95%CI 1.021~3.352,P<0.05;female:95%CI 1.021~4.045,P<0.05).Conclusion There was a statistical correlation between polysomnography AHI and carotid atherosclerosis.After adjusting for background factors,this statistical relationship still exists.It can be inferred that untreated obstructive sleep apnea is a risk factor for carotid atherosclerosis.

关 键 词：颈动脉粥样硬化 脑血管病 阻塞性睡眠呼吸暂停 危险因素 

分 类 号：R766[医药卫生—耳鼻咽喉科] R543.6[医药卫生—临床医学]