Objective Elderly patients with obstructive sleep apnea/hypopnea syndrome （OSAHS） has a higher risk of cardiovascular and cerebrovascular disease. However, changes of homocysteine （Hey） as markers of cardiovascula...Objective Elderly patients with obstructive sleep apnea/hypopnea syndrome （OSAHS） has a higher risk of cardiovascular and cerebrovascular disease. However, changes of homocysteine （Hey） as markers of cardiovascular and eerebrovascular disease associated with OSAHS and their mechanism have not been elucidated so far. This study aims to investigate the changes of both serum Hcy and oxidative stress and their possible links with OSAHS in elderly patients. Methods Based on polysomnogram （PSG） and age, 83 patients with OSAHS were recruited and divided into elderly-OSAHS （n=32） and non-elderly OSAHS groups （n=51）. Fifty two subjects without OSAHS were divided into elderly control （n=29） and non-elderly control groups （n-23）. A total of 135 subjects were included in the present study. All subjects were recorded for PSG variables and the contents of homocysteine （Hcy）, malonaldehyde （MDA）, and glutathione （GSH） which were detected after sleep. Serum homocysteine was measured by cyclophorase. MDA and GSH were measured by speetrophotometer. Results （1） The serum levels of Hcy showed significant difference among the four groups （P〈0.05）. The concentrations of Hcy in elderly OSAHS patients were higher than in other groups, while those in the elderly control group were higher than in the non-elderly control; the concentrations in the non-elderly OSAHS group were higher than in the non-elderly control. （2） The concentrations of MDA and GSH changed at an equal pace with Hcy in the four groups. （3） Multielement linearity regression analysis indicated a statistically significant relationship between Hcy concentration and age, MDA, GSH, and apnea hypopnea index （AHI）. Conclusions （1） The concentrations of Hcy and oxidative stress have increased with advancing age. （2） The concentrations of Hcy and oxidative stress have further increased in the elderly patients with OSAHS. （3） Oxidative stress might cause high-level serum Hcy in the elderly patients with OSAHS.展开更多
OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial inf...OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction(AMI).METHODS We prospectively enrolled 252 AMI elderly patients(mean age,68.5±6.9 years)who were undergoing revascularization and completed a sleep study during their hospitalization.All subjects were categorized into non-OSA(apnea–hypopnea index(AHI)<15,n=130)and OSA(AHI≥15,n=122)groups based on the AHI.The changes in the autonomic nervous system,incidence of arrhythmia during nocturnal sleep,and major adverse cardiovascular and cerebrovascular events(MACCEs)were compared between the groups.RESULTS The mean AHI value in all AMI patients was 22.8±10.9.OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation(Min Sa O2),as well as greater proportion of multivessel coronary artery disease(all P<0.05).The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset(both P<0.05)and higher incidence of arrhythmia(including sinus,atrial,and ventricular in origin).At a median follow-up of 6 months(mean 0.8–1.6 years),OSA(AHI≥15)combined with hypoxia(Min Sa O2≤80%)was independently associated with the incidence of MACCEs(hazard ratio[HR]:4.536;95%confidence interval[CI]:1.461-14.084,P=0.009)after adjusting for traditional risk factors.CONCLUSIONS OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction,increase the occurrence of heart rhythm disorders in elderly subacute MI patients,and worsen their short-term poor outcomes.展开更多
We describe here, a case with a giant epidermoid cyst in the floor of the mouth that caused severe obstructive sleep apnea syndrome (OSAS). A 37-year-old man was referred to our clinic because of a swelling in the flo...We describe here, a case with a giant epidermoid cyst in the floor of the mouth that caused severe obstructive sleep apnea syndrome (OSAS). A 37-year-old man was referred to our clinic because of a swelling in the floor of his mouth and sleep apnea syndrome. The occurrence of breathing disorders and daytime drowsiness was monitored to evaluate his OSAS 1 day before and 7 days after surgery. Before surgery, the apnea-hyponea index (AHI) and Epworth Sleepiness Scale (ESS) were 45.7 and 22, respectively. The clinical diagnosis was a dermoid or an epidermoid cyst that caused severe OSAS. Under general anesthesia, the patient underwent intraoral surgical removal of the cyst, along with aspiration to reduce the mass. After surgery, his sleep apnea syndrome was significantly improved. The postoperative AHI and ESS were 5.5 and 7, respectively. As of 2 years after the operation, there was no evidence of recurrence.展开更多
Objective To assess renal function in patients with obstructive sleep apnea syndrome (OSAS) during two nights when they were untreated and treated with continuous positive airway pressure (CPAP). Methods Tubular fu...Objective To assess renal function in patients with obstructive sleep apnea syndrome (OSAS) during two nights when they were untreated and treated with continuous positive airway pressure (CPAP). Methods Tubular function was estimated on the basis of the renal lithium clearance and its derived formulae, urinary osmolality, osmolal clearance and free water clearance; while glomerular function was evaluated by endogenous creatinine clearance. Twenty patients with OSAS and sixteen normal controls were studied. Results The untreated patients with OSAS had significantly lower fractional proximal tubular sodium reabsorption (59.1%±7.1%,P<0.001 vs controls), lower fractional distal tubular sodium reabsorption (93.8%±1.7%, P<0.05 vs controls) and urinary osmolality (573.0±107.9 mosm·kg 1 , P<0.05 vs controls). The absolute distal tubular reabsorption rate of sodium and osmolal clearance in the untreated patients were higher 47.0±26.0 mmol·L 1 and 25.0±4.1 ml·L 1 ; P< 0.01 and P<0.05 respectively vs controls). During CPAP treated nights all abnormal renal function indexes in the OSAS patients restored to normal control values (P>0.05). Conclusions The natriuresis and diuresis of OSAS patients were due to the decrease in proximal and distal tubular sodium reabsorption and in tubular concentration ability during their nocturnal sleep and were returned to normal by CPAP therapy.展开更多
目的探究并分析基于互联网模式的延续性护理在脑小血管病并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用。方法选取2021年7月至2022年1月治疗的119例脑小血管病并OSAHS患者,按照随机数字表法将其分为观察组(59例)和对照组(60例)...目的探究并分析基于互联网模式的延续性护理在脑小血管病并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用。方法选取2021年7月至2022年1月治疗的119例脑小血管病并OSAHS患者,按照随机数字表法将其分为观察组(59例)和对照组(60例)。对照组采用常规护理干预,观察组患者采用基于互联网模式的延续性护理。收集2组患者一般资料,观察并记录2组患者干预前后AHI指数、ESS评分,干预依从性及焦虑抑郁评分。结果观察组患者AHI指数显著低于对照组(15.36±1.37 v s13.54±1.35,P<0.05),干预3个月,观察组患者依从性显著高于对照组(6.85±0.89 vs 8.43±0.86,P<0.05),观察组患者SAS、SDS评分显著低于对照组(P<0.05),干预后1、3个月观察组患者生活质量显著高于对照组(P<0.05),差异有统计学意义。结论基于互联网模式的延续性护理能有效缓解脑小血管病并OSAHS患者睡眠呼吸暂停症状,改善患者治疗依从性,帮助患者调整心理状态,从而提高患者生活质量,值得临床推广。展开更多
基金supported by the National Natural Science Foundation of China (No.30330540)the Clinical Immunology Key Laboratory of Jiangsu Province Fund (No.200319)
文摘Objective Elderly patients with obstructive sleep apnea/hypopnea syndrome （OSAHS） has a higher risk of cardiovascular and cerebrovascular disease. However, changes of homocysteine （Hey） as markers of cardiovascular and eerebrovascular disease associated with OSAHS and their mechanism have not been elucidated so far. This study aims to investigate the changes of both serum Hcy and oxidative stress and their possible links with OSAHS in elderly patients. Methods Based on polysomnogram （PSG） and age, 83 patients with OSAHS were recruited and divided into elderly-OSAHS （n=32） and non-elderly OSAHS groups （n=51）. Fifty two subjects without OSAHS were divided into elderly control （n=29） and non-elderly control groups （n-23）. A total of 135 subjects were included in the present study. All subjects were recorded for PSG variables and the contents of homocysteine （Hcy）, malonaldehyde （MDA）, and glutathione （GSH） which were detected after sleep. Serum homocysteine was measured by cyclophorase. MDA and GSH were measured by speetrophotometer. Results （1） The serum levels of Hcy showed significant difference among the four groups （P〈0.05）. The concentrations of Hcy in elderly OSAHS patients were higher than in other groups, while those in the elderly control group were higher than in the non-elderly control; the concentrations in the non-elderly OSAHS group were higher than in the non-elderly control. （2） The concentrations of MDA and GSH changed at an equal pace with Hcy in the four groups. （3） Multielement linearity regression analysis indicated a statistically significant relationship between Hcy concentration and age, MDA, GSH, and apnea hypopnea index （AHI）. Conclusions （1） The concentrations of Hcy and oxidative stress have increased with advancing age. （2） The concentrations of Hcy and oxidative stress have further increased in the elderly patients with OSAHS. （3） Oxidative stress might cause high-level serum Hcy in the elderly patients with OSAHS.
基金supported by National Natural Science Youth Fund of China(81100098)Shanghai Municipal Commission of Health and Family Planning for Key Discipline Establishment(2015ZB0503&201840083)Production,Teaching and Research Program for University Teachers in Shanghai(RC20190079)。
文摘OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction(AMI).METHODS We prospectively enrolled 252 AMI elderly patients(mean age,68.5±6.9 years)who were undergoing revascularization and completed a sleep study during their hospitalization.All subjects were categorized into non-OSA(apnea–hypopnea index(AHI)<15,n=130)and OSA(AHI≥15,n=122)groups based on the AHI.The changes in the autonomic nervous system,incidence of arrhythmia during nocturnal sleep,and major adverse cardiovascular and cerebrovascular events(MACCEs)were compared between the groups.RESULTS The mean AHI value in all AMI patients was 22.8±10.9.OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation(Min Sa O2),as well as greater proportion of multivessel coronary artery disease(all P<0.05).The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset(both P<0.05)and higher incidence of arrhythmia(including sinus,atrial,and ventricular in origin).At a median follow-up of 6 months(mean 0.8–1.6 years),OSA(AHI≥15)combined with hypoxia(Min Sa O2≤80%)was independently associated with the incidence of MACCEs(hazard ratio[HR]:4.536;95%confidence interval[CI]:1.461-14.084,P=0.009)after adjusting for traditional risk factors.CONCLUSIONS OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction,increase the occurrence of heart rhythm disorders in elderly subacute MI patients,and worsen their short-term poor outcomes.
文摘We describe here, a case with a giant epidermoid cyst in the floor of the mouth that caused severe obstructive sleep apnea syndrome (OSAS). A 37-year-old man was referred to our clinic because of a swelling in the floor of his mouth and sleep apnea syndrome. The occurrence of breathing disorders and daytime drowsiness was monitored to evaluate his OSAS 1 day before and 7 days after surgery. Before surgery, the apnea-hyponea index (AHI) and Epworth Sleepiness Scale (ESS) were 45.7 and 22, respectively. The clinical diagnosis was a dermoid or an epidermoid cyst that caused severe OSAS. Under general anesthesia, the patient underwent intraoral surgical removal of the cyst, along with aspiration to reduce the mass. After surgery, his sleep apnea syndrome was significantly improved. The postoperative AHI and ESS were 5.5 and 7, respectively. As of 2 years after the operation, there was no evidence of recurrence.
文摘Objective To assess renal function in patients with obstructive sleep apnea syndrome (OSAS) during two nights when they were untreated and treated with continuous positive airway pressure (CPAP). Methods Tubular function was estimated on the basis of the renal lithium clearance and its derived formulae, urinary osmolality, osmolal clearance and free water clearance; while glomerular function was evaluated by endogenous creatinine clearance. Twenty patients with OSAS and sixteen normal controls were studied. Results The untreated patients with OSAS had significantly lower fractional proximal tubular sodium reabsorption (59.1%±7.1%,P<0.001 vs controls), lower fractional distal tubular sodium reabsorption (93.8%±1.7%, P<0.05 vs controls) and urinary osmolality (573.0±107.9 mosm·kg 1 , P<0.05 vs controls). The absolute distal tubular reabsorption rate of sodium and osmolal clearance in the untreated patients were higher 47.0±26.0 mmol·L 1 and 25.0±4.1 ml·L 1 ; P< 0.01 and P<0.05 respectively vs controls). During CPAP treated nights all abnormal renal function indexes in the OSAS patients restored to normal control values (P>0.05). Conclusions The natriuresis and diuresis of OSAS patients were due to the decrease in proximal and distal tubular sodium reabsorption and in tubular concentration ability during their nocturnal sleep and were returned to normal by CPAP therapy.
文摘目的探究并分析基于互联网模式的延续性护理在脑小血管病并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用。方法选取2021年7月至2022年1月治疗的119例脑小血管病并OSAHS患者,按照随机数字表法将其分为观察组(59例)和对照组(60例)。对照组采用常规护理干预,观察组患者采用基于互联网模式的延续性护理。收集2组患者一般资料,观察并记录2组患者干预前后AHI指数、ESS评分,干预依从性及焦虑抑郁评分。结果观察组患者AHI指数显著低于对照组(15.36±1.37 v s13.54±1.35,P<0.05),干预3个月,观察组患者依从性显著高于对照组(6.85±0.89 vs 8.43±0.86,P<0.05),观察组患者SAS、SDS评分显著低于对照组(P<0.05),干预后1、3个月观察组患者生活质量显著高于对照组(P<0.05),差异有统计学意义。结论基于互联网模式的延续性护理能有效缓解脑小血管病并OSAHS患者睡眠呼吸暂停症状,改善患者治疗依从性,帮助患者调整心理状态,从而提高患者生活质量,值得临床推广。
