OBJECTIVE: To study the effects of jaw advancement in treating micromandibular deformity associated with obstructive sleep apnea syndrome (OSAS) by ramus osteotomy and genioplasty. METHODS: From April 1998 to February 2002, 12 patients with micromandibular deformity associated with OSAS (aged 14-36 years, 7 females and 5 males) were treated. Invert "L" shape ramus osteotomy and inverted replantation of posterior segment of ramus were performed to reconstruct the TMJ with the jaw advancement and genioplasty at the same time in 7 cases; mandibular angle osteotomy, bone grafts and genioplasty in 3 cases; and the jaw advancement by ramus sagittal osteotomy and genioplasty in 2 cases of the first branchial arch syndrome. RESULTS: The follow-up period was 6 months to 4 years. All the patients gained good appearance and had the distance of opening movement over 3.0 cm. Micromandible and facial asymmetries were corrected satisfactorily. The ratio of SaO2 was ascended from 82%-92% (preoperation) to 97%-99% (postoperation). OSAS was relieved. CONCLUSION: The jaw advancement by ramus osteotomy and genioplasty for treating micromandibular deformity associated with OSAS can correct the maxillofacial deformities and enlarge the upper airway space to relieve OSAS. This method has achieved satisfactory result.
目的:探讨健康教育对高血压伴阻塞性睡眠呼吸暂停综合征（OSAS）的影响。方法:选择我院住院患者60例，随机分为二组，一组为实验组（入院后给予针对性健康教育），另一组为对照组（只给予一般健康教育）。结果:实验组3例患者病情控制快，血压、血脂、胆固醇控制良好，血氧饱和度恢复正常，与对照组相比，P＜0.05，有统计学意义。结论:加强对高血压伴OSAS患者的健康教育，将有助于改善其健康水平，提高治疗率及生活质量。
ObjectiveTo systematically review the association between obstructive sleep apnea syndrome and levels of thyroid hormone.MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 6, 2016), Web of Science, VIP, CNKI, WanFang Data, CBM and the relevant conference abstracts and unpublished literatures from inception to June, 2016 to collect the case-control studies about the levels of thyroid hormones with OSAS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software.ResultsA total of 8 RCTs involving 1 519 patients were included. The results of meta-analysis showed that: there were no significant differences of levels of FT3 between OSAS group and control group (mild: SMD=–0.01, 95%CI –0.21 to 0.20, P=0.93; moderate: SMD=0.15, 95%CI –0.34 to 0.64, P=0.55; severe: SMD=0.12, 95%CI –0.32 to 1.25, P=0.08). There were significant differences of levels of FT4 between mild and moderate OSAS groups with control group (mild: SMD=–0.49, 95%CI –0.74 to –0.25, P<0.000 1; moderate: SMD=–0.86, 95%CI –1.69 to –0.02, P=0.04), but no significant difference in severe group (SMD=–1.06, 95%CI –2.16 to 0.03, P=0.06). There were no significant differences of levels of TSH between OSAS group and control group (mild: SMD=–0.03, 95%CI –0.13 to 0.20, P=0.69; moderate: SMD=–0.09, 95%CI –0.27 to –0.10, P=0.35; severe: SMD=–0.02, 95%CI –0.26 to –0.22, P=0.88).ConclusionsThe current evidence shows that, OSAS is associated with lower levels of FT4. Due to the limited quality and quantity of included studies, the above results are needed to validate by more studies.
阻塞性睡眠呼吸暂停综合征( obstructive sleep apnea syndrome, OSAS) 是一种常见的睡眠呼吸障碍性疾病, 在成人发生率为2% ～4% , 由于睡眠中反复发生上气道部分或完全阻塞而表现为夜间间断低氧和高碳酸血症、反复觉醒、睡眠结构紊乱, 临床上常引起心、脑、肾等多器官损害。越来越多的证据表明, OSAS并发高血压、冠心病、肺动脉高压、心力衰竭、中风的危险性增高, 是心脑血管疾病的独立危险因素。未经治疗的重度OSAS 患者5 年病死率高达11% ～13% , 而心脑血管并发症是主要死因。如果及时给予有效治疗, 在一定程度上可以预防并发症的发生, 甚至逆转心脑血管并发症的转归。
Objective To investigate the levels of IL-6 and TNF-α in children with obstructive sleep apnea syndrome (OSAS) and to determine their clinical significance. Methods One hundred children with OSAS in our department from August 2005 to February 2006, and 40 healthy children were enrolled in the study. The serum levels of IL-6 and TNF-α were measured. Results Serum levels of IL-6 and TNF-α were significantly higher in patients with OSAS than those in the control group (Plt;0.05). Both IL-6 and TNF-α were not correlated with AHI. Conclusion It is concluded that OSAS is a chronic inflammatory process. A close correlation was observed between high levels of IL-6 and TNF-α and OSAS. High levels of IL-6 and TNF-α account for the risk factors in the development of cardiovascular diseases in children with OSAS.
阻塞性睡眠呼吸暂停综合征（OSAS）是在睡眠过程中上气道完全或部分狭窄导致患者反复呼吸暂停或低通气，出现鼾声、低氧血症及睡眠中反复微觉醒引起日间疲乏、嗜睡等症状的一组症候群。高血压是以体循环动脉压升高为主要特点的临床综合征，是最常见的心血管疾病，也是现代社会最主要的流行病之一。近十几年来，越来越多的研究证实OSAS与高血压的形成与发展独立相关，是非常重要的致高血压发生的危险因素[1-4]。 动脉压持续升高可导致心、脑、肾和血管等损害，并可引起全身代谢异常，严重危害人类的健康。但同时高血压又是可以防治的疾病，有效控制血压可明显地降低心脑血管疾病的死亡率。然而临床上难治性高血压的发生比例逐渐增加，原因之一在于部分由OSAS引起的继发性高血压被误诊为原发性高血压，从而使这些患者未得到根本性的病因治疗[5，6]。因此，如何预防和减少OSAS引起的高血压成为现代医学关注的焦点。本文将从流行病学、发病机制、临床意义及治疗几个方面论述OSAS与高血压之间的相关性。
Sleep disorder is related to many comorbidities, such as diabetes, obesity, cardiovascular diseases, and hypertension. Because of its increasing prevalence rate, it has become a global problem that seriously threatens people’s health. Various forms of sleep disorder can cause increased insulin resistance and/or decreased sensitivity, thus affecting the occurrence, development and prognosis of diabetes. However, sleep health has not been paid attention to in recent years. Therefore, this article summarizes the findings of the correlation between sleep disorder and diabetes mellitus in recent years, by elaborating the relationship between various types of sleep disorder (including sleep apnea syndrome) and diabetes mellitus, as well as their mechanisms and intervention measures, in order to enhance the attention of clinical workers to sleep health, and to provide basis for reducing the risk of diabetes.
Objective To investigate the clinical significance of changes in cardiopulmonary function, degree of hypoxia and inflammatory factors in obstructive sleep apnea hypopnea syndrome (OSAHS) patients combined chronic obstructive pulmonary disease (COPD). Methods A retrospective case-control study was conducted on 209 patients with OSAHS admitted from October 2015 to April 2022. The OSAHS patients were divided into an OSAHS-only group, an OSAHS combined with mild COPD group, an OSAHS combined with moderate COPD group, and an OSAHS combined with severe and very severe COPD group based on pulmonary function test. The characteristics of cardiopulmonary function [(pulmonary artery pressure, N terminal pro B type natriuretic peptide (NT-proBNP), forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), percent predicted value of FEV1 (FEV1%pred)], hypoxia indexes [night lowest saturation of pulse oxygen (NL-SpO2), night medial saturation of pulse oxygen (NM-SpO2), saturation of pulse oxygen less than 85% of the time (TS85), diurnal lowest saturation of pulse oxygen (DL-SpO2)], inflammatory factor indicators [procalcitonin (PCT), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), neutrophil to lymphocyte ratio (NLR)], and other characteristics were compared separately. The partial correlation analysis and logistic regression were used to analyze the influencing factors of OSAHS with COPD. Results There were statistically significant differences in age, days of hospitalization, cardiopulmonary function indexes, hypoxia indexes and inflammatory factor indexes between the OSAHS combined with COPD group and the OSAHS-only group (all P<0.05). And pulmonary artery pressure, NT-proBNP, TS85, IL-6, and NLR were higher and DL-SpO2, NL-SpO2, and NM-SpO2 were lower in the OSAHS combined with severe and very severe COPD group compared with the OSAHS combined with mild COPD group (all P<0.05). In the partial correlation analysis, FEV1%pred was negatively correlated with pulmonary artery pressure, NT-proBNP, TS85, IL-6, hs-CRP and NLR, and positively correlated with DL-SpO2, NL-SpO2 and NM-SpO2 (all P<0.05). In regression analysis, NLR and TS85 were the main risk factors for OSAHS combined with COPD (all P<0.05). Conclusions OSAHS patients combined with COPD have longer hospital days, greater burden of hypoxia, cardiopulmonary function and inflammation compared with patients with OSAHS alone, especially more significant in patients with poorer pulmonary function, and higher incidence of pulmonary heart disease, atrial fibrillation, and lower limb edema. NLR and TS85 are the main risk factors in patients with OSAHS combined with severe and very severe COPD.