低氧负荷在评估阻塞性睡眠呼吸暂停系统损害中的价值

Value of hypoxic burden in evaluating the impairments of organ systems in obstructive sleep apnea

阻塞性睡眠呼吸暂停(OSA)是由于上气道阻塞导致气流减少或暂停、以间歇性缺氧和睡眠片段化为特征的一种常见睡眠呼吸障碍。OSA可引起全身各靶器官系统的损害,尤以心血管系统为著,严重影响了患者的生活质量。因而,关于OSA引起系统性损害的评估以及评价指标的研究日益受到重视,以便对OSA进行早期预防和治疗。然而,由于睡眠呼吸暂停低通气指数(AHI)等传统指标在评估疾病严重性等方面具有局限性,有必要探索其他评价指标以获取OSA多维度的特征。低氧负荷可以更好地量化OSA的严重程度、捕捉OSA相关的疾病负荷。本文立足低氧负荷这一指标,综述其定义及提出、测算方法及其在OSA所致不良后果预测中的优势及临床意义,以期为对OSA患者实现更好的管理提供依据。

Obstructive sleep apnea(OSA)is a common sleep-disordered-breathing with decreased or even suspended ventilation due to upper airway obstruction,which is characterized by intermittent hypoxia and sleep fragmentation.OSA can damage a variety of organ systems,especially the cardiovascular system,seriously affecting the quality of life of patients.Therefore,more attention is paid to the precise assessment of the impairments of the organ systems caused by OSA and the evaluation of indicators,in order to carry out preventive measures as soon as possible.However,due to the limitations of traditional indicators such as apnea-hypopnea index(AHI)in assessing the severity of disease,it is necessary to explore other alternative indicators to obtain multi-dimensional characteristics of OSA.A promising parameter,hypoxic burden(HB)can better quantify the severity of OSA and capture the disease load of OSA.This review mainly focused on the basic concept,main features,calculating method of HB and its clinical significance in predicting the adverse consequences of OSA,aiming at a better management of patients with OSA.