阻塞性睡眠呼吸暂停综合征与心血管病关系的随访研究
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- 论文作者：慈书平 ; 尹志强 ; 张希龙 ; 王敏产 ; 吕耀欣 ; 倪竞全 ; 尤江南
- 英文论文作者：CI Shu-ping ; YIN Zhi-qiang ; ZHANG Xi-long ; WANG Min-chan ; LU Yao-xin ; NI Jing-quan ; YOU Jiang-nan ; Department of Elderly Medicine ; The 359th hospital of PLA
- 年：2012
- 作者机构：解放军第三五九医院老年病科;南京医科大学第一附属医院呼吸科;
- 论文关键词：睡眠呼吸暂停综合征 ; 心血管病 ; 流行病学调查 ; 随访
- 英文论文关键词：sleep apnea syndrome ; cardiovascular diseases ; epidemiological survey ; follow-up
- 会议召开时间：2012-09-29
- 会议录名称：第二届海峡两岸中医心理学睡眠医学论坛论文汇编
- 英文会议录名称：Proceedings of the 2nd Cross-Straits TCM Psychology & Sleep Medicine Forum
- 语种：中文
- 分类号：R766;R54
- 学会代码：YXSM
- 会议名称：第二届海峡两岸中医心理学睡眠医学论坛
- 会议地点：中国台湾台北
- 主办单位：世界中医药学会联合会中医心理学专业委员会、世界中医药学会联合会睡眠医学专业委员会
- 学会名称：世界中医药学会联合会睡眠医学专业委员会
- 页数：8
- 文件大小：583k
- 原文格式：D
- 会议级别：全国
摘要
目的调查随访阻塞性睡眠呼吸暂停综合征(OSAS)与心血管病的关系。方法对1989年11月至2009年11月1868例人群进行前瞻性随访,通过家访式调查,随访期间每年进行1次体检,检查血压、血脂、血糖、心电图及X线胸片等,发现存在心血管病表现时为随访终点,随访时间为20年。结果入选患者1868例,其中男956例,女912例,年龄范围53~82岁,男性平均65±7岁,女性平均60±6岁,总体平均年龄63±6岁。其中确诊OSAS者598(32.0%)例,男496(82.9%)例,女性102(17.1%)例。1270(68.0%)例无OSAS(对照组)。随访终点比较结果显示,OSAS组白天嗜睡、头痛、记忆力减退、痴呆及语言障碍等发生率明显高于对照组(P<0.05)。OSAS组502/598(83.9%)例发生心血管病,对照组发生363/1270(28.6%)例,(P<0.01)。随访期间死亡患者817例,其中OSAS组396/598(66.2%)例,对照组421/1270(33.1%,P<0.01)例。结论本组长期随访显示,OSAS患者发生心血管病可能性较一般人群高,考虑OSAS与发生心血管病存在相关性。20年随访提示OSAS可能是心血管病的独立危险因素。
Objective To explore the correlation between obstructive sleep apnea syndrome(OSAS) and cardiovascular diseases(HVD). Methods Prospective Home-visit questionaires for 1868 people were used from November 1989 to November2009,accompanied by annual medical examinations including blood pressure,blood-fat, serum glucose, electrocardiogram and chest x-ray. Computer tomography was carried out When HVD manifested,that was termination of follow-up,the period of follow-up lasted 20 years. Results Among 1868 elderly people, 598(32.0%)OSASpatients were made a definite diagnosis, in which 496(82.9%)were male, 102(17.1%)were female. Compared with 1270(68.0%) non-OSASgroup,their symptoms such as daytime somnolence, headache, decreased remembrance, aphronesia and allolalia significantly increased in OSAS group(P<0.05-0.01). patients who developed into HVD were 502/598(83.9%)in OSAS group, and 363/1270(28.6%),P<0.01)in non-OSAS group, respectively. 817 died at last in the course of 20 years, 396/598(66.2%) in OSAS group and 421/1270(33.1%, P<0.01) in non-OSAS group, respectively. Conclusion According to longtime follow-up, the probability of OSAS patient suffers from HVD is larger than the normal.We consider that there is a correlation between OSAS and HVD.At the end of our 20 years follow-up,OSAS may be an independent dangerous factor of HVD.
Objective To explore the correlation between obstructive sleep apnea syndrome(OSAS) and cardiovascular diseases(HVD). Methods Prospective Home-visit questionaires for 1868 people were used from November 1989 to November2009,accompanied by annual medical examinations including blood pressure,blood-fat, serum glucose, electrocardiogram and chest x-ray. Computer tomography was carried out When HVD manifested,that was termination of follow-up,the period of follow-up lasted 20 years. Results Among 1868 elderly people, 598(32.0%)OSASpatients were made a definite diagnosis, in which 496(82.9%)were male, 102(17.1%)were female. Compared with 1270(68.0%) non-OSASgroup,their symptoms such as daytime somnolence, headache, decreased remembrance, aphronesia and allolalia significantly increased in OSAS group(P<0.05-0.01). patients who developed into HVD were 502/598(83.9%)in OSAS group, and 363/1270(28.6%),P<0.01)in non-OSAS group, respectively. 817 died at last in the course of 20 years, 396/598(66.2%) in OSAS group and 421/1270(33.1%, P<0.01) in non-OSAS group, respectively. Conclusion According to longtime follow-up, the probability of OSAS patient suffers from HVD is larger than the normal.We consider that there is a correlation between OSAS and HVD.At the end of our 20 years follow-up,OSAS may be an independent dangerous factor of HVD.
引文
[1]黄席珍,李云龙,吴全有,等.阻塞性睡眠呼吸暂停综合征的诊断及外科治疗[J].中华医学杂志,1987,67:587
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[6]慈书平,李晖,宋红,等.睡眠呼吸暂停对血压昼夜节律和内皮素的影响[J].中华结核和呼吸杂志,1996,19(4):229-231
[7]李世琪,王旭红.成人阻塞性睡眠呼吸暂停低通气综合征与心血管疾病关系的探讨[J].中西医结合心脑血管病杂志,2010,8(1):119-120
[8]Lee SA,Amis TC,Byth K,et al.Heavy Snoring as a Cause of Carotid Artery Atherosclerosis[J].Sleep,2008,31(9):1207-1213.
[9]Zhang Xilong,Yin Kaisheng,Jia En Zhi,et al.Investigation on Risk Factor of Vascular Thrombotic Diseases in Patients with Obstructive Sleep Apnea Hypopnea Syndrome[J].Vasc Dis Prevention 2006,3(1):15-17
[10]Zhang Xilong,Yin Kaisheng,Wang Hong,et al.Effect of continuous positibve airway pressure treatment on elderly Chinese patients with obstructive sleep apnea in the prethrombotic state[J].Chin Med J,2003,116(9):1426-1428
[11]慈书平,许圣宣,郭俊武,等.老年睡眠呼吸暂停综合征与多器官疾病关系研究[J].实用老年医学杂志,2003,17(6):303-305
[12]慈书平,张希龙,杨宇,等.睡眠与睡眠疾病[M].北京:军事医学科学出版社,2005:320-407
[13]杨向军,徐新献,惠杰.现代内科急重症治疗学[M].成都:四川科学技术出版社,2010:1-298
[2]John W,Shepard Jr.Hypertetension,cardiac arrhythmias,myocardial infarction,and stroke in relation to obstructive sleep apnea.Clin Chest Med,1992,13:437-43
[3]Punjabi NM.The epidemiology of adult obstructive sleep apnea[J].Proc Am Thorac.2008,5(2):136-43.
[4]徐家军,慈书平,刘树森.鼾症对心脑血管疾病影响的长期随访[J].实用心脑肺血管病杂,1998,6(3):24-25
[5]慈书平,高义,张希龙,茅建华,赵宁志,倪竟全,沈翔,丁敏,徐新献.阻塞性睡眠呼吸暂停与脑血管病关系20年随访研究[J].中华结核和呼吸杂志,2011,34(1):13-16
[6]慈书平,李晖,宋红,等.睡眠呼吸暂停对血压昼夜节律和内皮素的影响[J].中华结核和呼吸杂志,1996,19(4):229-231
[7]李世琪,王旭红.成人阻塞性睡眠呼吸暂停低通气综合征与心血管疾病关系的探讨[J].中西医结合心脑血管病杂志,2010,8(1):119-120
[8]Lee SA,Amis TC,Byth K,et al.Heavy Snoring as a Cause of Carotid Artery Atherosclerosis[J].Sleep,2008,31(9):1207-1213.
[9]Zhang Xilong,Yin Kaisheng,Jia En Zhi,et al.Investigation on Risk Factor of Vascular Thrombotic Diseases in Patients with Obstructive Sleep Apnea Hypopnea Syndrome[J].Vasc Dis Prevention 2006,3(1):15-17
[10]Zhang Xilong,Yin Kaisheng,Wang Hong,et al.Effect of continuous positibve airway pressure treatment on elderly Chinese patients with obstructive sleep apnea in the prethrombotic state[J].Chin Med J,2003,116(9):1426-1428
[11]慈书平,许圣宣,郭俊武,等.老年睡眠呼吸暂停综合征与多器官疾病关系研究[J].实用老年医学杂志,2003,17(6):303-305
[12]慈书平,张希龙,杨宇,等.睡眠与睡眠疾病[M].北京:军事医学科学出版社,2005:320-407
[13]杨向军,徐新献,惠杰.现代内科急重症治疗学[M].成都:四川科学技术出版社,2010:1-298