受睡眠相关呼吸障碍影响的患者的肺动脉高压:最新文献。
Pulmonary hypertension in patients affected by sleep-related breathing disorders: up to date from the literature.
发表日期:2024 Jul 17
作者:
Elvia Battaglia, Elena Compalati, Luca Mapelli, Agata Lax, Paola Pierucci, Paolo Solidoro, Paolo Banfi
来源:
MINERVA MEDICA
摘要:
睡眠相关呼吸障碍(SBD)是睡眠期间呼吸异常和困难的病症,包括慢性打鼾、阻塞性睡眠呼吸暂停(OSA)、中枢性睡眠呼吸暂停(CSA)、睡眠相关通气不足障碍和睡眠相关低氧血症。其中一些对健康的影响有限,但另一些(例如 OSA)可能会产生严重后果,因为它们对睡眠以及氧气和二氧化碳的血液平衡产生危险影响。根据几项基于人群的研究,OSA 的患病率相对较高,一般人群中成年男性的患病率约为 3-7%,成年女性的患病率约为 2-5%。然而,方法上的差异和描述这种综合征的困难导致了估计的可变性。此外,据估计,只有约 40% 的 OSA 患者得到诊断,这可能导致疾病患病率的低估。 OSA 与年龄、男性性别以及肥胖等危险因素直接相关。多项研究发现,OSA 与糖尿病、某些癌症、心脑血管疾病(如高血压、冠状动脉疾病和中风)的风险增加有关。肺动脉高压 (PH) 是一种著名的心血管疾病,与睡眠相关的呼吸障碍显着相关,文献中发表的大量科学研究表明这些疾病与肺动脉高压 PH 的发展之间存在密切联系。与睡眠相关的呼吸障碍相比,PH 相对较少见。本系统评价的目的是分析目前关于 SBD 可能对肺血流动力学影响的知识,以及 SDB 药物和非药物治疗对 PH 的影响。
Sleep-related breathing disorders (SBD) are conditions of abnormal and difficult respiration during sleep, including chronic snoring, obstructive sleep apnea (OSA), central sleep apnea (CSA), sleep-related hypoventilation disorders and sleep-related hypoxemia. Some of them have a limited impact on health, but others (e.g., OSA) can have serious consequences, because of their dangerous effects on sleep and the hematic balance of oxygen and carbon dioxide. According to several population-based studies, prevalence of OSA is relatively high, approximately 3-7% for adult males and 2-5% for adult females in the general population. However, methodological differences and difficulties in characterizing this syndrome yielded to variability in estimates. Moreover, it is estimated that only about 40% of patients with OSA are diagnosed, which can lead to underestimation of disease prevalence. OSA is directly correlated with age and male sex and to risk factors such as obesity. Several studies found that OSA is associated with an increased risk of diabetes, some cancer types, cardiovascular and cerebrovascular diseases, such as hypertension, coronary artery disease and stroke. Pulmonary hypertension (PH), a noted cardiovascular disease, is significantly associated with sleep-related breathing disorders and lot of scientific studies published in the literature demonstrated a strong link between these conditions and the development of pulmonary hypertension PH. PH is relatively less common than sleep-related breathing disorders. The purpose of this systematic review is to analyze both the current knowledge around the consequences that SBD may have on pulmonary hemodynamics and the effects resulting from pharmacological and non-pharmacological treatments of SDB on PH.