睡眠呼吸暂停综合征和支气管哮喘相互促进及其作用机制

Relationship between obstructive sleep apnea syndrome and asthma and the possible mechanism

近年来的研究提示，睡眠呼吸暂停综合征和支气管哮喘（简称哮喘）之间关系密切，睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）是哮喘急性发作的独立危险因素。OSAS促进哮喘加重的可能机制包括以下方面：胃食管反流，气道炎症反应，神经反射机制，OSAS相关的心血管损害的间接影响，血管内皮生长因子，气道高反应性，缺氧诱导因子相关的气道重塑，肥胖；哮喘患者易合并OSAS的可能机制：鼻塞，上气道咽部横断面积的减少，以及上气道塌陷性增加；以上均提示这两种疾病存在相关性。明确OSAS和哮喘相互关联的本质对两种疾病的治疗有重要意义。

Recent research suggests, obstructive sleep apnea syndrome （OSAS） and bronchial asthma （asthma） may influence each other. OSAS is an independent risk factor for asthma. The possible mechanism of OSAS which promotes asthma exacerbations includes the following aspects： gastroesophageal reflux, airway inflammation, neural reflex mechanisms, the indirect effects of cardiovascular harm caused by OSAS, airway vascular proliferation induced by VEGF, airway hyperresponsieness, obesity. The following reasons may be why asthma easil}~ merger OSAS： nasal congestion, the cross sectional area reductions of the upper respiratory tract, and the increased airway collapse. It is suggested that there is a correlation between the two diseases. Therefore, a clear mechanism of the interaction between OSAS and asthma can provide a valuable therapeutic strategy for the two disease.