类风湿性关节炎伴睡眠呼吸暂停综合征的发病机制及治疗研究进展
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摘要
睡眠呼吸暂停综合征(sleep apnea hypopnea syndrome,OSAHS)是临床常见的睡眠呼吸疾病,主要临床表现为睡眠中出现呼吸气量降低或是呼吸暂停,而且部分患者会伴有打鼾症状,当患者长时间持续出现间断呼吸气量降低或呼吸暂停时,就会导致机体出现间歇性低氧,致使组织缺氧,引发机体氧化应激反应、炎性反应等。类风湿性关节炎(rheumatoid arthritis,RA)是一种全身性疾病,累及关节滑膜增生、软骨糜烂和关节损伤。在类风湿性关节炎发病机制中起关键作用的是滑膜衬里层成纤维样滑膜细胞(fibroblast like synoviocytes,FLS),该病症主要就是机体一系类炎症反应导致患者关节损伤,出现关节功能障碍,影响患者的生活质量。本文首先概述了类风湿性关节炎的疾病特性,分析了类风湿性关节炎伴睡眠呼吸暂停综合征的发病机制,探讨了类风湿性关节炎与睡眠呼吸暂停之间的关系,并重点论述了类风湿性关节炎伴睡眠呼吸暂停综合征的治疗进展。
Sleep apnea hypopnea syndrome (OSAHS) is a common clinical sleep-disordered disease.The main clinical manifestations are decreased respiratory volume or apnea during sleep,and some patients may have snoring symptoms.If patients continue to have the intermittent respiratory volume reduction or apnea for a long time,it will lead to intermittent hypoxia in the body,result in tissue hypoxia and cause the body's oxidative stress and inflammatory reactions.Rheumatoid arthritis(RA)is a systemic disease involving joint synovial hyperplasia,cartilage erosion,and joint damage.Fibroblast like synoviocytes (FLS) play a key role in the pathogenesis of rheumatoid arthritis.This disease is mainly caused by a series of inflammatory reactions in the body,leading to joint damage and joint function.Obstacles affect the quality of life of patients.This article first summarizes the disease characteristics of rheumatoid arthritis,analyzes the pathogenesis of rheumatoid arthritis with sleep apnea syndrome,discusses the relationship between rheumatoid arthritis and sleep apnea,and focuses on progress in the treatment of rheumatoid arthritis with sleep apnea syndrome.
Sleep apnea hypopnea syndrome (OSAHS) is a common clinical sleep-disordered disease.The main clinical manifestations are decreased respiratory volume or apnea during sleep,and some patients may have snoring symptoms.If patients continue to have the intermittent respiratory volume reduction or apnea for a long time,it will lead to intermittent hypoxia in the body,result in tissue hypoxia and cause the body's oxidative stress and inflammatory reactions.Rheumatoid arthritis(RA)is a systemic disease involving joint synovial hyperplasia,cartilage erosion,and joint damage.Fibroblast like synoviocytes (FLS) play a key role in the pathogenesis of rheumatoid arthritis.This disease is mainly caused by a series of inflammatory reactions in the body,leading to joint damage and joint function.Obstacles affect the quality of life of patients.This article first summarizes the disease characteristics of rheumatoid arthritis,analyzes the pathogenesis of rheumatoid arthritis with sleep apnea syndrome,discusses the relationship between rheumatoid arthritis and sleep apnea,and focuses on progress in the treatment of rheumatoid arthritis with sleep apnea syndrome.
引文
1黄斌,杨增荣,黄毅,等.阻塞性睡眠呼吸暂停低通气综合征的治疗研究进展[J].重庆医学,2016,45(30):4300-4303.
2 Peromaahaavisto P,Tuomilehto H,K9ssi J,et al.Prevalence of obstructive sleep apnoea among patients admitted for bariatric surgery.aprospective multicentre trial[J].Obesity Surgery,2016,26(7):1384-1390.
3张萍,郭文佳.OSAHS与心血管疾病的研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,35(6):442-445.
4 Grassi G,Seravalle G,Quartitrevano F,et al.Reinforcement of the adrenergic overdrive in the metabolic syndrome complicated by obstructive sleep apnea[J].Journal of Hypertension,2016,28(6):1313-1320.
5黄金莎,王涛.中枢性睡眠呼吸暂停治疗方法进展[J].中华神经科杂志,2017,50(1):74-78.
6 Altintas N,Mutlu LC,Akkoyun DC,et al.Effect of CPAP on new endothelial dysfunction marker,endocan,in people with obstructive sleep apnea[J].Angiology,2016,67(4):364-374.
7黄振贤,王巧静.上颌快速扩弓治疗儿童阻塞性睡眠呼吸暂停综合征的研究进展[J].国际口腔医学杂志,2017,44(2):218-221.
8 Almendros I,Khalyfa A,Trzepizur W,et al.Tumor cell malignant properties are enhanced by circulating exosomes in sleep apnea[J].Chest,2016,150(5):1030-1041.
9高远,李永吉.类风湿性关节炎发病机制及中药靶向治疗的研究进展[J].中国药房,2016,27(35):5030-5034.
10 Korson R,Guilleminault C.Obstructive sleep apnea syndrome[J].Clinics in Chest Medicine,2017,31(2):187-201.
11纪前前,郭伟伟,张倩倩,等.JAK抑制剂在类风湿性关节炎治疗中的研究进展[J].中国药房,2016,27(5):711-713.
12 Nishijima T,Tajima K,Yamashiro Y,et al.Elevated plasma levels of soluble(pro)renin receptor in patients with obstructive sleep apnea syndrome in parallel with the disease severity[J].Tohoku Journal of Experimental Medicine,2016,238(4):325-338.
13胡晓敏,宗英,余珊珊,等.类风湿关节炎治疗药物的研发进展及趋势[J].中国新药杂志,2017,58(1):36-43.
14 Jr SJ,Anstead AS,Wong H.Complications in children who electively remain intubated after adenotonsillectomy for severe obstructive sleep apnea[J].International Journal of Pediatric Otorhinolaryngology,2016,73(8):1095-1099.
15闫秀清,王芳芳,王学彬.时间治疗学在类风湿关节炎中的研究进展[J].中华风湿病学杂志,2016,25(1):55-58.
16 Serra-Torres S,Bellot-Arcís C,Montiel-Company JM,et al.Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome:Asystematic review[J].Laryngoscope,2016,126(2):507-514.
17肖水芳,贾俊晓,张俊波.阻塞性睡眠呼吸暂停低通气综合征治疗进展[J].临床耳鼻咽喉头颈外科杂志,2016,36(24):1909-1912.
18 Kim H,Joo EY,Suh S,et al.Effects of long-term treatment on brain volume in patients with obstructive sleep apnea syndrome[J].Human Brain Mapping,2016,37(1):395-409.
19刘萌雅,姚红兵.儿童阻塞性睡眠呼吸暂停低通气综合征的病理生理及治疗进展[J].重庆医学,2016,25(3):421-423.
20 Yaggi HK,Mittleman MA,Bravata DM,et al.Reducing cardiovascular risk through treatment of obstructive sleep apnea:2methodological approaches[J].American Heart Journal,2016,172(2):135-143.
21 Gupta MA,Jarosz P.Obstructive sleep apnea severity is directly related to suicidal ideation in posttraumatic stress disorder[J].J Clin Sleep Med,2018,14(3):427-435.
22 Motamedi V,Kanefsky R,Matsangas P,et al.Elevated tau and interleukin-6concentrations in adults with obstructive sleep apnea[J].Sleep Med,2018,3(43):71-76.
23田培燕,陈应康,谢福珊,等.阻塞性睡眠呼吸暂停综合征模型大鼠心肌氧化应激的损伤及复氧后的变化[J].中国现代医学杂志,2017,27(13):24-27.
24 Li L,Ren F,Qi C,et al.Intermittent hypoxia promotes melanoma lung metastasis via oxidative stress and inflammation responses in a mouse model of obstructive sleep apnea[J].Respir Res,2018,19(1):28-39.
25 Hensen HA,Krishnan AV,Eckert DJ.Sleep-disordered breathing in people with multiple sclerosis:Prevalence,pathophysiological mechanisms,and disease consequences[J].Front Neurol,2018,15(8):740-749.
26郭凤霞,储德节.持续正压通气对OSAHS合并2型糖尿病患者睡眠、糖代谢及氧化应激的影响[J].临床肺科杂志,2017,22(11):1962-1965.
27 Chen L,Zadi ZH,Zhang J,et al.Intermittent hypoxia in utero damages postnatal growth and cardiovascular function in rats[J].J Appl Physiol(1985),2018,124(4):821-830.
28 Snyder B,Cunningham RL.Sex differences in sleep apnea and comorbid neurodegenerative diseases[J].Steroids,2018,5(133):28-33.
29唐燕,高晓玲,李建强.阻塞性睡眠呼吸暂停低通气综合征相关血清学标志物研究进展[J].中华医学杂志,2017,97(12):954-957.
30 Naismith SL,Mowszowski L.Sleep disturbance in mild cognitive impairment:a systematic review of recent findings[J].Curr Opin Psychiatry,2018,31(2):153-159.
2 Peromaahaavisto P,Tuomilehto H,K9ssi J,et al.Prevalence of obstructive sleep apnoea among patients admitted for bariatric surgery.aprospective multicentre trial[J].Obesity Surgery,2016,26(7):1384-1390.
3张萍,郭文佳.OSAHS与心血管疾病的研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,35(6):442-445.
4 Grassi G,Seravalle G,Quartitrevano F,et al.Reinforcement of the adrenergic overdrive in the metabolic syndrome complicated by obstructive sleep apnea[J].Journal of Hypertension,2016,28(6):1313-1320.
5黄金莎,王涛.中枢性睡眠呼吸暂停治疗方法进展[J].中华神经科杂志,2017,50(1):74-78.
6 Altintas N,Mutlu LC,Akkoyun DC,et al.Effect of CPAP on new endothelial dysfunction marker,endocan,in people with obstructive sleep apnea[J].Angiology,2016,67(4):364-374.
7黄振贤,王巧静.上颌快速扩弓治疗儿童阻塞性睡眠呼吸暂停综合征的研究进展[J].国际口腔医学杂志,2017,44(2):218-221.
8 Almendros I,Khalyfa A,Trzepizur W,et al.Tumor cell malignant properties are enhanced by circulating exosomes in sleep apnea[J].Chest,2016,150(5):1030-1041.
9高远,李永吉.类风湿性关节炎发病机制及中药靶向治疗的研究进展[J].中国药房,2016,27(35):5030-5034.
10 Korson R,Guilleminault C.Obstructive sleep apnea syndrome[J].Clinics in Chest Medicine,2017,31(2):187-201.
11纪前前,郭伟伟,张倩倩,等.JAK抑制剂在类风湿性关节炎治疗中的研究进展[J].中国药房,2016,27(5):711-713.
12 Nishijima T,Tajima K,Yamashiro Y,et al.Elevated plasma levels of soluble(pro)renin receptor in patients with obstructive sleep apnea syndrome in parallel with the disease severity[J].Tohoku Journal of Experimental Medicine,2016,238(4):325-338.
13胡晓敏,宗英,余珊珊,等.类风湿关节炎治疗药物的研发进展及趋势[J].中国新药杂志,2017,58(1):36-43.
14 Jr SJ,Anstead AS,Wong H.Complications in children who electively remain intubated after adenotonsillectomy for severe obstructive sleep apnea[J].International Journal of Pediatric Otorhinolaryngology,2016,73(8):1095-1099.
15闫秀清,王芳芳,王学彬.时间治疗学在类风湿关节炎中的研究进展[J].中华风湿病学杂志,2016,25(1):55-58.
16 Serra-Torres S,Bellot-Arcís C,Montiel-Company JM,et al.Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome:Asystematic review[J].Laryngoscope,2016,126(2):507-514.
17肖水芳,贾俊晓,张俊波.阻塞性睡眠呼吸暂停低通气综合征治疗进展[J].临床耳鼻咽喉头颈外科杂志,2016,36(24):1909-1912.
18 Kim H,Joo EY,Suh S,et al.Effects of long-term treatment on brain volume in patients with obstructive sleep apnea syndrome[J].Human Brain Mapping,2016,37(1):395-409.
19刘萌雅,姚红兵.儿童阻塞性睡眠呼吸暂停低通气综合征的病理生理及治疗进展[J].重庆医学,2016,25(3):421-423.
20 Yaggi HK,Mittleman MA,Bravata DM,et al.Reducing cardiovascular risk through treatment of obstructive sleep apnea:2methodological approaches[J].American Heart Journal,2016,172(2):135-143.
21 Gupta MA,Jarosz P.Obstructive sleep apnea severity is directly related to suicidal ideation in posttraumatic stress disorder[J].J Clin Sleep Med,2018,14(3):427-435.
22 Motamedi V,Kanefsky R,Matsangas P,et al.Elevated tau and interleukin-6concentrations in adults with obstructive sleep apnea[J].Sleep Med,2018,3(43):71-76.
23田培燕,陈应康,谢福珊,等.阻塞性睡眠呼吸暂停综合征模型大鼠心肌氧化应激的损伤及复氧后的变化[J].中国现代医学杂志,2017,27(13):24-27.
24 Li L,Ren F,Qi C,et al.Intermittent hypoxia promotes melanoma lung metastasis via oxidative stress and inflammation responses in a mouse model of obstructive sleep apnea[J].Respir Res,2018,19(1):28-39.
25 Hensen HA,Krishnan AV,Eckert DJ.Sleep-disordered breathing in people with multiple sclerosis:Prevalence,pathophysiological mechanisms,and disease consequences[J].Front Neurol,2018,15(8):740-749.
26郭凤霞,储德节.持续正压通气对OSAHS合并2型糖尿病患者睡眠、糖代谢及氧化应激的影响[J].临床肺科杂志,2017,22(11):1962-1965.
27 Chen L,Zadi ZH,Zhang J,et al.Intermittent hypoxia in utero damages postnatal growth and cardiovascular function in rats[J].J Appl Physiol(1985),2018,124(4):821-830.
28 Snyder B,Cunningham RL.Sex differences in sleep apnea and comorbid neurodegenerative diseases[J].Steroids,2018,5(133):28-33.
29唐燕,高晓玲,李建强.阻塞性睡眠呼吸暂停低通气综合征相关血清学标志物研究进展[J].中华医学杂志,2017,97(12):954-957.
30 Naismith SL,Mowszowski L.Sleep disturbance in mild cognitive impairment:a systematic review of recent findings[J].Curr Opin Psychiatry,2018,31(2):153-159.