冠心病与睡眠呼吸暂停综合征关系的Meta分析

A meta-analysis on the relationship between sleep apnea syndrome and coronary artery disease

目的:通过Meta分析有关冠心病与睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)关系的病例对照研究的文献,为冠心病与SAS相互关系的研究提供循证医学的证据。方法:收集和整理有关冠心病与SAS关系的病例对照研究的文献,观察对比冠心病和非冠心病患者群中SAS的发生率,用RevMan 5.2分析软件、Stata12SE分析软件对纳入的研究进行异质性检验和合并分析,结果以比数比(odds ratio,OR)表示,计算95%可信区间(95%CI),评估发表性偏倚和敏感性检验。结果:纳入的14组研究根据SAS定义不同分为两组分析,分析前9项研究显示OR=2.95,95%CI(2.25-3.87),P<0.05,差异有统计学意义;后5项研究R=3.42,95%CI(1.74-6.71),P<0.05,差异有统计学意义,表示SAS发生率与冠心病具有正的关联性,经检验不存在发表偏倚且敏感度分析示稳定度较高。结论:冠心病患者群中SAS的发生率高于非冠心病患者,SAS是冠心病的危险因素。

AIM： To analyze case-control studies on the relationship between coronary artery diseases （CAD） and sleep apnea syndrome （SAS） and to provide support of evidence-based medicine for studies regarding SAS and CAD. METHODS： Literature reports of case-control studies on the relationship between CAD and SAS were collected and the morbidity of SAS in CAD group and non-CAD group was compared. Heterogeneity and original data were analyzed by Statal2 and RevManS. 2 and the outcomes were indicated by OR and 95 % CI. Publication bias and sensitivity were also tested. RESULTS ： Selected studies were categorized into two groups according to different definitions of SAS. The outcomes of the first group with nine studies were statistically significant （OR=2.95, 95% CI 2.25 -3. 87, P 〈0.05） and the outcomes of the second group with five studies were also statistically significant （ OR = 3.42, 95% CI 1.74-6. 71, P 〈 0.05 ）. Bias test showed no publication bias and sensitivity analysis showed that the results were stable. The morbidity of SAS showed a positive correlation with CAD. CONCLUSION ： The morbidity of SAS in CAD patients is higher than in patients without CAD. SAS is a risk factor for CAD.