阻塞性睡眠呼吸暫停低通氣綜合征對心血管系統的影響_Chinese Journal of Respiratory and Critical Care Medicine

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孫凱 , 韓瑞娟 , 趙瑞平

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阻塞性睡眠呼吸暫停低通氣綜合征

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睡眠呼吸暫停低通氣綜合征（SAHS）是指各種原因導致睡眠狀態下反復出現呼吸暫停和（或）低通氣，引起低氧血癥、高碳酸血癥，從而使機體發生一系列病理生理改變的臨床綜合征。按病因分為三型：阻塞型、中樞型和混和型。阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）臨床較為常見，Young等[1]報道男性發病率為4%，女性為2％。近年研究表明，OSAHS與心血管疾病關系密切，是高血壓、冠心病、心律失常、心力衰竭等心血管疾病的獨立危險因素，是臨床上猝死的常見原因之一[2-5]。OSAHS可使自主神經系統失調而誘發心律失常[6，7]，增加心血管病的發病率和死亡率[8]。本文就近年OSAHS對心血管系統的影響的相關文獻做一綜述。

Citation： 孫凱,韓瑞娟,趙瑞平. 阻塞性睡眠呼吸暫停低通氣綜合征對心血管系統的影響. 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，吳海英，劉力生.睡眠呼吸暫停綜合征與高血壓治療.中華心血管病雜志，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，王廷礎，盧紅霞，等.阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓患者睡眠結構分析及血清內皮素-1的測定.中華耳鼻喉科雜志，2004，39：116-119.
14.	李延忠，張萬榮，王廷礎，等.黏附分子在阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓發病中的作用.中華結核和呼吸雜志，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.	郭繼鴻.睡眠呼吸暫停對心血管系統的危害不容低估.中華醫學雜志，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，吳海英，劉力生.睡眠呼吸暫停綜合征與高血壓治療.中華心血管病雜志，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，王廷礎，盧紅霞，等.阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓患者睡眠結構分析及血清內皮素-1的測定.中華耳鼻喉科雜志，2004，39：116-119.
14. 李延忠，張萬榮，王廷礎，等.黏附分子在阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓發病中的作用.中華結核和呼吸雜志，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. 郭繼鴻.睡眠呼吸暫停對心血管系統的危害不容低估.中華醫學雜志，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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