阻塞性睡眠呼吸暂停综合征与冠心病关系的研究进展

Research progress of the relationship between obstructive sleep apnea syndrome and coronary heart disease

阻塞性睡眠呼吸暂停综合征(OSAS)已被确认为冠心病(CHD)的一个重要的独立危险因素,影响CHD的发生发展。其机制尚不完全清楚,可能与间歇性缺氧、交感神经激活、氧化应激、高凝状态、炎症反应、内皮功能损害、代谢异常等有关。关于持续正压通气对CHD是否有积极意义尚有争议。该文简述了OSAS分型、诊断的关键方面,着重讨论OSAS参与CHD的可能机制,回顾了目前持续正压通气治疗对CHD影响的证据,并对CHD合并OSAS患者的治疗提出了展望。

Obstructive sleep apnea syndrome(OSAS)has been repeatedly recognized as an important independent risk factor of coronary heart disease(CHD),affecting the occurrence and development of CHD.The mechanisms are not fully understood,and may be related to intermittent hypoxia,sympathetic nerve activation,oxidative stress,hypercoagulability,inflammatory response,endothelial dysfunction and metabolic abnormalities.Whether continuous positive airway pressure(CPAP)has a positive effect on CHD remains controversial.In this paper,the key aspects of the classification and diagnosis of OSAS are summarized,and the possible mechanisms of OSAS involving in CHD are mainly discussed;the current evidence of the effect of CPAP on CHD is reviewed,and the prospects for the treatment of patients with CHD complicated with OSAS are proposed.