成都地區中老年人群打鼾情況與心血管疾病危險因素的關系_《華西醫學》

作者：

呂政兵 , 何森 ,  陳曉平

四川大學華西醫院心血管內科（成都, 610041）;

關鍵詞：

打鼾高血壓心血管疾病

DOI：

10.7507/1002-0179.20130156

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目的　阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）可引起心血管疾病發生增高，是高血壓病及冠心病等的獨立危險因素。打鼾是OSAHs的主要臨床癥狀。本研究的主要目的是了解成都地區自然人群打鼾發生情況及其與心血管疾病危險因素的關系。方法　2007年在成都市成華區采用隨機抽樣方法對男、女性共711人進行了心血管疾病危險因素調查[年齡45～80歲，平均（3.28 ± 6.25）歲，男性患者占所有患者的57.8%]，主要包括問卷調查、體格檢查及血液學檢查等，其中打鼾調查主要包括打鼾時間、次數及憋醒情況。將與打鼾相關的3個指標綜合考慮后，計算出打鼾的嚴重程度，并分析了其與心血管疾病危險因素的關系。結果　男性人群中打鼾率較女性高（62.0%、51.0%，P=0.003），且重度及極重度打鼾率也較女性高。隨著打鼾的嚴重程度增加，體質量指數、血肌酐及尿酸等心血管疾病危險因素逐漸升高（趨勢P均＜0.05），而高密度脂蛋白膽固醇逐漸降低（P=0.001）。另外，隨著打鼾的嚴重程度增加，高血壓患病率及收縮壓也逐漸升高，但無統計學意義（趨勢P=0.063，0.08）。結論　成都地區中老年城鎮人群的打鼾率較高，且男性高于女性。另外，隨著打鼾的嚴重程度增加，心血管疾病危險因素也逐漸升高。這提示我們在臨床工作中，對于打鼾的患者需要加強心血管疾病危險因素的篩查及干預，以期減少它的發生發展。

引用本文： 呂政兵,何森,陳曉平. 成都地區中老年人群打鼾情況與心血管疾病危險因素的關系. 華西醫學, 2013, 28(4): 485-488. doi: 10.7507/1002-0179.20130156 復制

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12.	World Health Organization. Multinational monitoring of trends and determinants in cardiovascular diseases (MONICA Project) and manual of operation[R]. Geneva, Switzerland: World Health Organization, Cardiovascular Disease Unit, 1983.
13.	Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome Study[J]. Am J Hypertens, 2007, 20(8): 819-824.
14.	Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up[J]. Am J Respir Crit Care Med, 2002, 166(2): 159-165.
15.	Cho N, Joo S, Kim J, et al. Relation of habitual snoring with components of metabolic syndrome in Korean adults[J]. Diabetes Res and Clin Pr, 2006, 71(3): 256-263.
16.	Dart RA, Gregoire JR, Gutterman DD, et al. The association of hypertension and secondary cardiovascular disease with sleep-disordered breathing[J]. Chest, 2003, 123(1): 244-260.
17.	Hu FB, Willett WC, Manson JE, et al. Snoring and risk of cardiovascular disease in women[J]. J Am Coll Cardiol, 2000, 35(2): 308-313.
18.	YOUNG, L Finn, KM Hla, et al. Snoring as part of a dose-response relationship between sleep-disordered breathing and blood pressure[J]. Sleep, 1996, 19(Suppl 10): 202-205.
19.	Gozal D, Kheirandish L. Oxidant stress and inflammation in the snoring child: confluent pathways to upper airway pathogenesis and end-organ morbidity[J]. Sleep Med Rev, 2006, 10(2): 83-96.
20.	Yeboah J, Redline S, Johnson C, et al. Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA[J]. Atherosclerosis, 2011, 219(2): 963-968.
21.	Lao XQ, Neil Thomas G, Jiang CQ, et al. Obesity, high-sensitive C-reactive protein and snoring in older Chinese: The guangzhou biobank cohort study[J]. Resp Med, 2010, 104(11): 1750-1756.
22.	Shin C, Kim J, Kim J, et al. Association of habitual snoring with glucose and insulin metabolism in nonobese korean adult men[J]. Am J Resp Crit Care, 2005, 171(3): 287-291.
23.	Al-Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for typeⅡ diabetes mellitus: a prospective study[J]. Am J Epidemiol, 2002, 155(5): 387-393.

1. 　Seckin OU. Snoring and obstructive sleep apnea[J]. Med Clin N Am, 2010, 94(5): 1047-1055.
2. 　Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea[J]. Am J Resp Crit Care, 2002, 166(2): 159-165.
3. 　Leineweber C, Kecklund G, Janszky I, et al. Snoring and progression of coronary artery disease: the stockholm female coronary angiography study[J]. Sleep, 2004, 27(7): 1344-1349.
4. 　Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome study[J]. Am J Hypertens, 2007, 20(8): 819-824.
5. 　Thomas GN, Jiang C, Lao X, et al. Snoring and vascular risk factors and disease in a low-risk Chinese population: the guangzhou biobank cohort study[J]. Sleep , 2006, 29(7): 896-900.
6. 　Hoffstein V. Snoring[J]. Chest, 1996, 109(1): 201-222.
7. 　劉建紅, 梁大華, 韋彩周, 等. 廣西地區打鼾人群血壓狀況分析 [J]. 中華結核和呼吸雜志, 2007, 30(5): 347-351.
8. 　Lindberg E, Berne C, Franklin KA, et al. Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women-a population-based study[J]. Resp Med, 2007, 101(6): 1283-1290.
9. 　Zamarrón C, Gude F, Otero YO, et al. Snoring and myocardial infarction: a 4-year follow-up study[J]. Resp Med, 1999, 93(2): 108-112.
10. 　Lindberg E, Janson C, Gislason T, et al. Snoring and hypertension: a 10 year follow-up[J]. Eur Respir J, 1998, 11(4): 884-889.
11. 　Koskenvuo M, Kaprio J, Telakivi T, et al. Snoring as a risk factor for ischaemic heart disease and stroke in men[J]. BMJ, 1987, 294(6563): 16-19.
12. 　World Health Organization. Multinational monitoring of trends and determinants in cardiovascular diseases (MONICA Project) and manual of operation[R]. Geneva, Switzerland: World Health Organization, Cardiovascular Disease Unit, 1983.
13. 　Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome Study[J]. Am J Hypertens, 2007, 20(8): 819-824.
14. 　Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up[J]. Am J Respir Crit Care Med, 2002, 166(2): 159-165.
15. 　Cho N, Joo S, Kim J, et al. Relation of habitual snoring with components of metabolic syndrome in Korean adults[J]. Diabetes Res and Clin Pr, 2006, 71(3): 256-263.
16. 　Dart RA, Gregoire JR, Gutterman DD, et al. The association of hypertension and secondary cardiovascular disease with sleep-disordered breathing[J]. Chest, 2003, 123(1): 244-260.
17. 　Hu FB, Willett WC, Manson JE, et al. Snoring and risk of cardiovascular disease in women[J]. J Am Coll Cardiol, 2000, 35(2): 308-313.
18. 　YOUNG, L Finn, KM Hla, et al. Snoring as part of a dose-response relationship between sleep-disordered breathing and blood pressure[J]. Sleep, 1996, 19(Suppl 10): 202-205.
19. 　Gozal D, Kheirandish L. Oxidant stress and inflammation in the snoring child: confluent pathways to upper airway pathogenesis and end-organ morbidity[J]. Sleep Med Rev, 2006, 10(2): 83-96.
20. 　Yeboah J, Redline S, Johnson C, et al. Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA[J]. Atherosclerosis, 2011, 219(2): 963-968.
21. 　Lao XQ, Neil Thomas G, Jiang CQ, et al. Obesity, high-sensitive C-reactive protein and snoring in older Chinese: The guangzhou biobank cohort study[J]. Resp Med, 2010, 104(11): 1750-1756.
22. 　Shin C, Kim J, Kim J, et al. Association of habitual snoring with glucose and insulin metabolism in nonobese korean adult men[J]. Am J Resp Crit Care, 2005, 171(3): 287-291.
23. 　Al-Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for typeⅡ diabetes mellitus: a prospective study[J]. Am J Epidemiol, 2002, 155(5): 387-393.

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成都地區中老年人群打鼾情況與心血管疾病危險因素的關系

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