阻塞性睡眠呼吸暂停与血脂紊乱的研究进展  

Advances in the association between obstructive sleep apnea and dyslipidemia

作　　者：彭裕 卫志成 高怡青 许华俊[1] 李馨仪 易红良[1] 关建[1] 殷善开[1] Peng Yu;Wei Zhicheng;Gao Yiqing;Xu Huajun;Li Xinyi;Yi Hongliang;Guan Jian;Yin Shankai(Department of Otolaryngology-Head and Neck Surgery,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院耳鼻咽喉头颈外科,上海200233

出　　处：《国际呼吸杂志》2024年第4期490-496,共7页International Journal of Respiration

基　　金：科技创新2030-"脑科学及类脑研究"重大项目(2021ZD0201900);上海市科学技术委员会科技创新行动计划(18DZ2260200)。

摘　　要：阻塞性睡眠呼吸暂停(OSA)作为一种高患病率、波及全身系统的慢性睡眠呼吸障碍疾病备受关注。近年来,该病症与脂代谢紊乱相联系的证据不断涌现,肥胖和胰岛素抵抗又作为重要的合并症使两者的关系研究陷入混淆。动物实验表明OSA通过以间歇性缺氧和睡眠碎片化为中心的病理生理机制影响脂质的合成、释放、分解途径,诱发血脂异常。除了因果关联,OSA与血脂异常还具有遗传共性。OSA的各种治疗手段如持续正压通气治疗、口腔矫治器、上气道手术对血脂产生一定改善,结合减重代谢治疗能发挥更大的效果。多学科的联合有利于OSA和血脂的管理。Obstructive sleep apnea(OSA)has received significant attention as a chronic sleep disorder due to its widespread prevalence and systemic implications.Recent researches have increasingly linked this condition with dyslipidemia,where the influence of obesity and insulin resistance serves as significant confounding factors.Animal experiments have elucidated that OSA contributes to dyslipidemia by disrupting lipid synthesis,release,and catabolism pathways.These pathophysiological mechanisms primarily revolve around intermittent hypoxia and sleep fragmentation.Beyond causal associations,there exist genetic commonalities between OSA and dyslipidemia.Treatments such as continuous positive airway pressure,oral appliances,and upper airway surgeries have demonstrated some efficacy in improving lipid profiles,and their effectiveness appears to be augmented when combined with metabolic interventions aimed at weight loss.A multidisciplinary approach is essential for the comprehensive management of both OSA and lipid-related disorders.

关 键 词：阻塞性睡眠呼吸暂停 血脂异常 肥胖 胰岛素抵抗 

分 类 号：R766[医药卫生—耳鼻咽喉科] R589.2[医药卫生—临床医学]