光学相干断层血管成像技术评估阻塞性睡眠呼吸暂停综合征患者视网膜血管特点的Meta分析  

Retinal vascular characteristics in patients with obstructive sleep apnea syndrome assessed by optical coherence tomography angiography:a meta-analysis

作　　者：许云鹏 石沛东 姜仔怡 张镭 雷迅文[3] 武凡祺[4] 郭鸿 刘健 XU Yunpeng;SHI Peidong;JIANG Ziyi;ZHANG Lei;LEI Xunwen;WU Fanqi;GUO Hong;LIU Jian(The First School of Clinical Medicine,Lanzhou University,Lanzhou,Gansu 730000,P.R.China;The Second Clinical Medical College of Lanzhou University,Lanzhou,Gansu 730000,P.R.China;Department of Ophthalmology,The First Hospital of Lanzhou University,Lanzhou,Gansu 730000,P.R.China;Department of Pulmonary and Critical Care Medicine,The Second Hospital of Lanzhou University,Lanzhou,Gansu 730000,P.R.China;Intensive Care Unit,Gansu Province Maternity and Child-Care Hospital(Gansu Provincial Central Hospital),Lanzhou,Gansu 730070,P.R.China;Gansu Province Maternity and Child-Care Hospital(Gansu Provincial Central Hospital),Lanzhou,Gansu 730070,P.R.China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]兰州大学第一医院眼科,甘肃兰州730000 [4]兰州大学第二医院呼吸与危重症医学科,甘肃兰州730000 [5]甘肃省妇幼保健院(甘肃省中心医院)重症医学科,甘肃兰州730070 [6]甘肃省妇幼保健院(甘肃省中心医院),甘肃兰州730070

出　　处：《中国呼吸与危重监护杂志》2025年第3期157-166,共10页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：甘肃省重点研发资助项目(20YF8FA082);“萃英科技创新”计划-临床拔尖技术研究项目(CY2023-BJ-04);兰州大学学生创新创业行动计划资助项目(20240050069)。

摘　　要：目的评价光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)技术在阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)中的应用价值。方法计算机检索国内外数据库关于OCTA测量在OSAS中应用的临床研究,检索日期为建库至2024年5月,利用Revman 5.4软件进行Meta分析。结果初检134篇文献,经过筛选最终纳入14篇符合标准的文献,共999例研究对象,OSAS组739例,健康组260例。Meta分析结果显示:在视网膜浅层毛细血管丛(superficial capillary plexus,SCP)密度方面,OSAS组在中央凹区(MD=–2.05,95%CI–3.75~–0.35,P=0.02)、凹周区(MD=–1.56,95%CI–2.44~–0.68,P=0.0005)显著低于健康组;OSAS轻中度组在中央凹区(MD=–2.41,95%CI–4.32~–0.49,P=0.01)、凹旁区(MD=–1.17,95%CI–2.01~–0.32,P=0.007)、凹周区(MD=–1.73,95%CI–2.69~–0.77,P=0.0004)均显著低于健康组;OSAS重度组在凹周区(MD=–1.33,95%CI–2.53~–0.13,P=0.03)显著低于健康组;OSAS轻中度组在全区(MD=0.36,95%CI 0.05~0.68,P=0.02)显著高于OSAS重度组。在视网膜深层毛细血管丛(deep capillary plexus,DCP)密度方面,OSAS组在全区(MD=–2.16,95%CI–3.51~–0.81,P=0.002)、中央凹区(MD=–2.38,95%CI–4.38~–0.37,P=0.02)、凹旁区(MD=–2.33,95%CI–3.93~–0.73,P=0.004)均显著低于健康组;OSAS轻中度组在全区(MD=–2.02,95%CI–3.33~–0.72,P=0.002)、凹旁区(MD=–1.65,95%CI–3.04~–0.26,P=0.02)显著低于健康组;OSAS重度组在全区(MD=–2.26,95%CI–3.85~–0.66,P=0.006)、凹旁区(MD=–1.47,95%CI–2.31~–0.62,P=0.0007)显著低于健康组;OSAS轻中度组在全区(MD=0.54,95%CI 0.02~1.07,P=0.04)显著高于OSAS重度组。在视网膜神经纤维层(retinal nerve fibre layer,RNFL)厚度方面,OSAS轻中度组在下方象限(MD=4.01,95%CI 0.69~7.32,P=0.02)、颞侧象限(MD=4.35,95%CI 1.88~6.82,P=0.0006)显著高于OSAS重度组。在中央凹无血管区(foveal avascular zone,FAZ)面积方面,OSAS重度组的FAZ面积(MD=0.06,9Objective To evaluate the application value of optical coherence tomography angiography(OCTA)in obstructive sleep apnea syndrome(OSAS).Methods A comprehensive search of both domestic and international databases was conducted to identify clinical studies on the use of OCTA in OSAS,from the establishment of the databases to May 2024.A meta-analysis was performed using Revman 5.4 software.Results A total of 134 studies were initially identified,with 14 studies meeting the inclusion criteria,encompassing 999 subjects(739 in the OSAS group and 260 in the healthy group).Meta-analysis results indicated that the superficial capillary plexus(SCP)density in the fovea(MD=–2.05,95%CI–3.75 to–0.35,P=0.02)and parafovea(MD=–1.56,95%CI–2.44 to–0.68,P=0.0005)was significantly lower in the OSAS group compared with the healthy group.In the mild to moderate OSAS group,SCP density was significantly lower in the fovea(MD=–2.41,95%CI–4.32 to–0.49,P=0.01),parafovea(MD=–1.17,95%CI–2.01 to–0.32,P=0.007),and perifovea(MD=–1.73,95%CI–2.69 to–0.77,P=0.0004)compared with the healthy group.In the severe OSAS group,SCP density in the perifovea(MD=–1.33,95%CI–2.53 to–0.13,P=0.03)was significantly lower than that of the healthy group.SCP density in the whole area(MD=0.36,95%CI 0.05 to 0.68,P=0.02)was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group.In the deep capillary plexus(DCP)density,the OSAS group showed significantly lower densities in the whole area(MD=–2.16,95%CI–3.51 to–0.81,P=0.002),fovea(MD=–2.38,95%CI–4.38 to–0.37,P=0.02),and parafovea(MD=–2.33,95%CI–3.93 to–0.73,P=0.004)compared with the healthy group.The mild to moderate OSAS group also showed significantly lower densities in the whole area(MD=–2.02,95%CI–3.33 to–0.72,P=0.002)and parafovea(MD=–1.65,95%CI–3.04 to–0.26,P=0.02)compared with the healthy group.The severe OSAS group had significantly lower DCP density in the whole area(MD=–2.26,95%CI–3.85 to–0.66,P=0.006)and

关 键 词：阻塞性睡眠呼吸暂停 光学相干断层扫描血管成像 META分析 

分 类 号：R76[医药卫生—耳鼻咽喉科]