|
阻塞性睡眠呼吸暂停综合征伴缺血性脑血管病与颅内外血管斑块的研究进展
|
Abstract:
目前尚不清楚阻塞性睡眠呼吸暂停综合征合并脑血管疾病患者与颅内外血管斑块之间是否存在直接或间接的因果关系,有研究证实,阻塞性睡眠呼吸暂停综合征与缺血性脑血管疾病的发生密切相关。许多研究表明:阻塞性睡眠呼吸暂停综合征是缺血性脑血管疾病的一个独立危险因素,阻塞性睡眠呼吸暂停综合征病人在夜间睡眠期间会反复出现呼吸暂停、间歇性低氧血症,该变化可引起血管内皮功能障碍、炎性因子增加、代谢紊乱,导致动脉粥样硬化斑块发生率增加,目前阻塞性睡眠呼吸暂停综合征与动脉血管的斑块成分、斑块稳定性的研究较少,具体机制尚不明确,阻塞性睡眠呼吸暂停综合征是否会影响斑块的稳定性,导致阻塞性睡眠呼吸暂停综合征病人更容易发生脑血管疾病,可通过影像学方面观察阻塞性睡眠呼吸暂停综合征与缺血性脑血管疾病患者颅内外血管斑块相关性进行分析,本文综述了阻塞性睡眠呼吸暂停综合征伴缺血性脑血管疾病患者与血管斑块的研究进展。
It is still unclear whether there is a direct or indirect causal relationship between patients with ob-structive sleep apnea syndrome and cerebrovascular disease and intracranial and intracranial vascular plaques. Studies have confirmed that obstructive sleep apnea syndrome and ischemic cerebrovascular plaques are closely related. Many studies have shown that obstructive sleep apnea syndrome is an independent risk factor for ischemic cerebrovascular disease. Patients with ob-structive sleep apnea syndrome will experience repeated apnea and intermittent hypoxemia dur-ing sleep at night. Changes can cause vascular endothelial dysfunction, increased inflammatory fac-tors, and metabolic disorders, leading to an increase in the incidence of atherosclerotic plaques. At present, studies on obstructive sleep apnea syndrome and arterial plaque components and plaque stability are less, the specific mechanism is not clear, whether obstructive sleep apnea syndrome will affect the stability of the plaque, making patients with obstructive sleep apnea syndrome more prone to cerebrovascular disease, obstructive sleep apnea syndrome can be observed by imaging. The correlation between sleep apnea syndrome and intracranial and intracranial vascular plaques in patients with ischemic cerebrovascular disease was analyzed. This article reviewed the research progress of patients with obstructive sleep apnea syndrome and ischemic cerebrovascular disease and vascular plaques.
[1] | Heinzer, R., Vat, S., Marques-Vidal, P., et al. (2015) Prevalence of Sleep-Disordered Breathing in the General Popula-tion: The HypnoLaus Study. The Lancet Respiratory Medicine, 3, 310-318.
https://doi.org/10.1016/S2213-2600(15)00043-0 |
[2] | Redline, S., Punjabi, N.M. and Yenokyan, G. (2011) Ob-structive Sleep Apnea-Hypopnea and Incident Stroke: The Sleep Heart Health Study. American Journal of Respiratory & Critical Care Medicine, 183, Article No. 950.
https://doi.org/10.1164/ajrccm.183.7.950a |
[3] | 曹毅, 唐海红, 何疆春, 殷忠, 马健, 杨晔. 老年阻塞性睡眠呼吸暂停综合征与脑卒中的相关性研究[J]. 中华老年心脑血管病杂志, 2015, 17(8): 834-836. |
[4] | Peker, Y., Carl-son, J. and Hedner, J. (2006) Increased Incidence of Coronary Artery Disease in Sleep Apnoea: A Long- Term Fol-low-Up. European Respiratory Journal, 28, 596-602. https://doi.org/10.1183/09031936.06.00107805 |
[5] | Nakashima, H., Kurobe, M., Minami, K., Furudono, S., Uchida, Y., et al. (2014) Effects of Moderate-to-Severe Obstructive Sleep Apnea on the Clinical Manifestations of Plaque Vulnerability and the Progression of Coronary Atherosclerosis in Patients with Acute Coronary Syndrome. European Heart Journal. Acute Cardiovascular Care, 4, 75-84. |
[6] | Ciccone, M.M., Scicchitano, P., Mitacchione, G., Favale, S., et al. (2012) Is There a Correlation between OSAS Duration/Severity and Carotid Intima-Media Thickness? Respiratory Medicine, 106, 740-746.
https://doi.org/10.1016/j.rmed.2011.12.016 |
[7] | Konishi, T., Kashiwagi, Y., Funayama, N., et al. (2019) Obstruc-tive Sleep Apnea Is Associated with Increased Coronary Plaque Instability: An Optical Frequency Domain Imaging Study. Heart and Vessels, 34, 1266-1279. |
[8] | Li, F., Chen, Q., Chen, Z., Tian, D. and Cai, Q. (2016) Magnetic Reso-nance Imaging of Plaque Burden in Vascular Walls of the Middle Cerebral Artery Correlates with Cerebral Infarction. Current Neurovascular Research, 13, 263-270.
https://doi.org/10.2174/1567202613666160829095324 |