阻塞性睡眠呼吸暂停低通气综合征对心血管系统的影响_Chinese Journal of Respiratory and Critical Care Medicine

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孙凯 , 韩瑞娟 , 赵瑞平

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阻塞性睡眠呼吸暂停低通气综合征

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睡眠呼吸暂停低通气综合征（SAHS）是指各种原因导致睡眠状态下反复出现呼吸暂停和（或）低通气，引起低氧血症、高碳酸血症，从而使机体发生一系列病理生理改变的临床综合征。按病因分为三型：阻塞型、中枢型和混和型。阻塞性睡眠呼吸暂停低通气综合征（OSAHS）临床较为常见，Young等[1]报道男性发病率为4%，女性为2％。近年研究表明，OSAHS与心血管疾病关系密切，是高血压、冠心病、心律失常、心力衰竭等心血管疾病的独立危险因素，是临床上猝死的常见原因之一[2-5]。OSAHS可使自主神经系统失调而诱发心律失常[6，7]，增加心血管病的发病率和死亡率[8]。本文就近年OSAHS对心血管系统的影响的相关文献做一综述。

Citation： 孙凯,韩瑞娟,赵瑞平. 阻塞性睡眠呼吸暂停低通气综合征对心血管系统的影响. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(5): 398-400. doi: Copy

1.	Young T，Palta M，Dempsey J，et al.The occurrence of sleep-disordered breathing among middle-aged adults.N Engl J Med，1993，328：1230-1235.
2.	Yumino D，Tsurumi Y，Takagi A.Impact of obstructive sleep apnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome.Am J Cardiol，2007，99：26-30.
3.	李莉，吴海英，刘力生.睡眠呼吸暂停综合征与高血压治疗.中华心血管病杂志，2004，32：30-32.
4.	Shiomi T，Sasanabe R，Otake K，et al.Physiopathology and complications of sleep apnea syndrome.Circulatory complications：obesity-related hypertension and obesity-related heart failure with obstructive sleep apnea.Nippon Naika Gakkai Zasshi，2004，93：1114-1119.
5.	Duchna HW，Myslinski W，Dichmann M，et al.Cardiac structure and function in patients with obstructive sleep apnea syndrome and co-prevalent arterial hypertension.Influence of CPAP therapy.Med Klin（Munich），2006，101：1-8.
6.	Aytemir K，Deniz A，Yavuz B，et al.Increased myocardial vulnerability and autonomic nervous system imbalance in obstructive sleep apnea syndrome.Respir Med，2006，6：1277-1282.
7.	Roche F，Xuong AN，Court-Fortune I，et al.Relationship among the severity of sleep apnea syndrome，cardiac arrhythmias，and autonomic imbalance.Pacing Clin Electrophysiol，2003，26：669-677.
8.	Marin JM，Carrizo SJ，Vicente E，et al.Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure：an observational study.Lancet，2005，365：1046-1053.
9.	Lavie P，Herer P，Hoffstein V.Obstructive sleep apnoea syndrome as a risk factor for hypertension：population study.BMJ，2000，320：479-482.
10.	Nieto FJ，Young TB，Lind BK，et al.Association of sleep-disordered breathing，sleep apnea，and hypertension in a large community-based study.Sleep Heart Health Study.JAMA，2000，283：1829-1836.
11.	Peppard PE，Young T，Palta M，et al.Prospective study of the association between sleep-disordered breathing and hypertension.N Engl J Med，2000，342：1378-1384.
12.	Logan AG，Perlikowski SM，Mente A，et al.High prevalence of unrecognized sleep apnoea in drug-resistant hypertension.J Hypertens，2001，19：2271-2277.
13.	李延忠，王廷础，卢红霞，等.阻塞性睡眠呼吸暂停低通气综合征合并高血压患者睡眠结构分析及血清内皮素-1的测定.中华耳鼻喉科杂志，2004，39：116-119.
14.	李延忠，张万荣，王廷础，等.黏附分子在阻塞性睡眠呼吸暂停低通气综合征合并高血压发病中的作用.中华结核和呼吸杂志，2004，27：511-514.
15.	Mooe T，Franklin KA，Wiklund U，et al.Sleep-disordered breathing and myocardial ischemia in patients with coronary artery disease.Chest，2000，117：1597-1602.
16.	Mooe T，Franklin KA，Holmstrom K，et al.Sleep-disordered breathing and coronary artery disease：long-term prognosis.Am J Respir Crit Care Med，2001，164：1910-1913.
17.	Skinner MA，Choudhury MS，Homan SDR，et al.Accuracy of monitoring for sleep-related breathing disorders in the coronary care unit.Chest，2005，127：66-71.
18.	Gami AS，Pressman G，Caples SM，et al.Association of atrial fibrillation and obstructive sleep apnea.Circulation，2004，110：364-367.
19.	Gami AS，Friedman PA，Chung MK，et al.Therapy Insight：interactions between atrial fibrillation and obstructive sleep apnea.Nat Clin Pract Cardiovasc Med，2005，2：145-149.
20.	Roche F，Barthelemy JC，Garet M，et al.Continuous positive airway pressure treatment improves the QT rate dependence adaptation of obstructive sleep apnea patients.Pacing Clin Electrophysiol，2005，28：819-825.
21.	郭继鸿.睡眠呼吸暂停对心血管系统的危害不容低估.中华医学杂志，2005，85：3099-3100.
22.	Garrigue S，Bordier P，Clementy J.Sleep apnea and cardiac pacing：mechanisms of action and perspectives.Ann Cardiol Angeiol（Paris），2003，52：239-245.
23.	Shahar E，Whitney CW，Redline S，et al.Sleep-disordered breathing and cardiovascular disease：cross-sectional results of the Sleep Heart Health Study.Am J Respir Crit Care Med，2001，163：19-25.
24.	Sin DD，Fitzgerald F，Parker JD，et al.Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure.Am J Respir Crit Care Med，1999，160：1101-1106.
25.	Borges AC，Knebel F，Eddicks S，et al.Right ventricular function assessed by two-dimensional strain and tissue Doppler echocardiography in patients with pulmonary arterial hypertension and effect of vasodilator therapy.Am J Cardiol，2006，98：530-534.
26.	Nakashima H，Katayama T，Takagi C，et al.Obstructive sleep apnoea inhibits the recovery of left ventricular function in patients with acute myocardial infarction.Eur Heart J，2006，27：2317-2322.

1. Young T，Palta M，Dempsey J，et al.The occurrence of sleep-disordered breathing among middle-aged adults.N Engl J Med，1993，328：1230-1235.
2. Yumino D，Tsurumi Y，Takagi A.Impact of obstructive sleep apnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome.Am J Cardiol，2007，99：26-30.
3. 李莉，吴海英，刘力生.睡眠呼吸暂停综合征与高血压治疗.中华心血管病杂志，2004，32：30-32.
4. Shiomi T，Sasanabe R，Otake K，et al.Physiopathology and complications of sleep apnea syndrome.Circulatory complications：obesity-related hypertension and obesity-related heart failure with obstructive sleep apnea.Nippon Naika Gakkai Zasshi，2004，93：1114-1119.
5. Duchna HW，Myslinski W，Dichmann M，et al.Cardiac structure and function in patients with obstructive sleep apnea syndrome and co-prevalent arterial hypertension.Influence of CPAP therapy.Med Klin（Munich），2006，101：1-8.
6. Aytemir K，Deniz A，Yavuz B，et al.Increased myocardial vulnerability and autonomic nervous system imbalance in obstructive sleep apnea syndrome.Respir Med，2006，6：1277-1282.
7. Roche F，Xuong AN，Court-Fortune I，et al.Relationship among the severity of sleep apnea syndrome，cardiac arrhythmias，and autonomic imbalance.Pacing Clin Electrophysiol，2003，26：669-677.
8. Marin JM，Carrizo SJ，Vicente E，et al.Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure：an observational study.Lancet，2005，365：1046-1053.
9. Lavie P，Herer P，Hoffstein V.Obstructive sleep apnoea syndrome as a risk factor for hypertension：population study.BMJ，2000，320：479-482.
10. Nieto FJ，Young TB，Lind BK，et al.Association of sleep-disordered breathing，sleep apnea，and hypertension in a large community-based study.Sleep Heart Health Study.JAMA，2000，283：1829-1836.
11. Peppard PE，Young T，Palta M，et al.Prospective study of the association between sleep-disordered breathing and hypertension.N Engl J Med，2000，342：1378-1384.
12. Logan AG，Perlikowski SM，Mente A，et al.High prevalence of unrecognized sleep apnoea in drug-resistant hypertension.J Hypertens，2001，19：2271-2277.
13. 李延忠，王廷础，卢红霞，等.阻塞性睡眠呼吸暂停低通气综合征合并高血压患者睡眠结构分析及血清内皮素-1的测定.中华耳鼻喉科杂志，2004，39：116-119.
14. 李延忠，张万荣，王廷础，等.黏附分子在阻塞性睡眠呼吸暂停低通气综合征合并高血压发病中的作用.中华结核和呼吸杂志，2004，27：511-514.
15. Mooe T，Franklin KA，Wiklund U，et al.Sleep-disordered breathing and myocardial ischemia in patients with coronary artery disease.Chest，2000，117：1597-1602.
16. Mooe T，Franklin KA，Holmstrom K，et al.Sleep-disordered breathing and coronary artery disease：long-term prognosis.Am J Respir Crit Care Med，2001，164：1910-1913.
17. Skinner MA，Choudhury MS，Homan SDR，et al.Accuracy of monitoring for sleep-related breathing disorders in the coronary care unit.Chest，2005，127：66-71.
18. Gami AS，Pressman G，Caples SM，et al.Association of atrial fibrillation and obstructive sleep apnea.Circulation，2004，110：364-367.
19. Gami AS，Friedman PA，Chung MK，et al.Therapy Insight：interactions between atrial fibrillation and obstructive sleep apnea.Nat Clin Pract Cardiovasc Med，2005，2：145-149.
20. Roche F，Barthelemy JC，Garet M，et al.Continuous positive airway pressure treatment improves the QT rate dependence adaptation of obstructive sleep apnea patients.Pacing Clin Electrophysiol，2005，28：819-825.
21. 郭继鸿.睡眠呼吸暂停对心血管系统的危害不容低估.中华医学杂志，2005，85：3099-3100.
22. Garrigue S，Bordier P，Clementy J.Sleep apnea and cardiac pacing：mechanisms of action and perspectives.Ann Cardiol Angeiol（Paris），2003，52：239-245.
23. Shahar E，Whitney CW，Redline S，et al.Sleep-disordered breathing and cardiovascular disease：cross-sectional results of the Sleep Heart Health Study.Am J Respir Crit Care Med，2001，163：19-25.
24. Sin DD，Fitzgerald F，Parker JD，et al.Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure.Am J Respir Crit Care Med，1999，160：1101-1106.
25. Borges AC，Knebel F，Eddicks S，et al.Right ventricular function assessed by two-dimensional strain and tissue Doppler echocardiography in patients with pulmonary arterial hypertension and effect of vasodilator therapy.Am J Cardiol，2006，98：530-534.
26. Nakashima H，Katayama T，Takagi C，et al.Obstructive sleep apnoea inhibits the recovery of left ventricular function in patients with acute myocardial infarction.Eur Heart J，2006，27：2317-2322.

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