阻塞性睡眠呼吸暂停与急性冠状动脉综合征相关发病机制及诊疗进展

Progress in the pathogenesis and diagnosis of obstructive sleep apnea and acute coronary syndrome

阻塞性睡眠呼吸暂停(OSA)是一种临床常见睡眠相关疾病,此疾病多由于肥胖所致舌根部及扁桃体增大压迫、先天性颌面畸形、喉部肌肉松弛等因素导致气道狭窄,阻力增加。主要临床表现为睡眠过程中反复出现上呼吸道的完全或不完全阻塞,表现为呼吸暂停和低通气,进一步导致间歇性低氧血症、高碳酸血症及睡眠结构紊乱。急性冠状动脉综合征(ACS)是冠状动脉粥样硬化性心脏病中常见的一个类型,其以发病率高、死亡率高著称。近年来,ISAACC、SAVE、OSA-ACS等从多方面对OSA和ACS进行了研究,本文将从疾病流行病学、病理生理学、临床诊断/评估及医学干预等多个方面对OSA合并ACS进行综述,探索两者间的相关性。

Obstructive sleep apnea is a common clinical sleep-related disease,which is mainly due to obesity,enlargement and compression of the root of the tongue and tonsils,congenital maxillofacial malformation,laryngeal muscle relaxation and other factors leading to airway stenosis and increased resistance.The main clinical manifestations are recurrent complete or incomplete obstruction of the upper respiratory tract during sleep,manifested as apnea and hypopnea,which further lead to intermittent hypoxemia,hypercapnia and disturbed sleep structure.Acute coronary syndrome is a common type of coronary atherosclerotic heart disease,which is known for its high morbidity and mortality.In recent years,ISAACC,SAVE,OSA-ACS and other studies have conducted a large number of studies on OSA and ACS from many aspects,and this paper will review OSA combined with ACS from multiple aspects of disease epidemiology,pathophysiology,clinical diagnosis/evaluation and medical intervention,to explore the correlation between them.