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阻塞性睡眠呼吸暂停与心血管并发症:认知与知识的差距。

Obstructive sleep apnoea and cardiovascular complications: perception versus knowledge.

机构信息

Division of Kinesiology and Health & Biomedical Science, University of Wyoming College of Health Sciences, Laramie, WY, USA.

出版信息

Clin Exp Pharmacol Physiol. 2012 Dec;39(12):995-1003. doi: 10.1111/1440-1681.12024.

Abstract

Epidemiological evidence has confirmed that obstructive sleep apnoea (OSA) significantly promotes cardiovascular risk, independent of age, sex, race and other common risk factors for cardiovascular diseases, such as smoking, drinking, obesity, diabetes mellitus, dyslipidaemia and hypertension. Patients with severe OSA exhibit a higher prevalence of coronary artery disease, heart failure and stroke. Despite the tight correlation between sleep apnoea and these comorbidities, the mechanisms behind increased cardiovascular risk in OSA remain elusive. Several theories have been postulated, including sympathetic activation, endothelial dysfunction, oxidative stress and inflammation. The association between OSA and cardiovascular diseases may be rather complicated and compounded by the presence of components of metabolic syndrome, such as obesity, hypertension, diabetes mellitus and dyslipidaemia. The present minireview updates current knowledge with regard to the cardiovascular sequelae of OSA and the mechanisms involved.

摘要

流行病学证据已经证实,阻塞性睡眠呼吸暂停(OSA)显著增加了心血管风险,独立于年龄、性别、种族和其他常见心血管疾病的危险因素,如吸烟、饮酒、肥胖、糖尿病、血脂异常和高血压。重度 OSA 患者冠心病、心力衰竭和中风的患病率更高。尽管睡眠呼吸暂停与这些合并症之间存在紧密关联,但 OSA 中增加心血管风险的机制仍难以捉摸。已经提出了几种理论,包括交感神经激活、内皮功能障碍、氧化应激和炎症。OSA 与心血管疾病之间的关联可能相当复杂,并可能因代谢综合征的成分(如肥胖、高血压、糖尿病和血脂异常)的存在而变得更加复杂。本篇迷你综述更新了关于 OSA 的心血管后果及其相关机制的现有知识。

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