OSAHS的可能发病机制、对人体的危害及诊疗新进展

发布时间：2018-07-24 11:12

【摘要】： OSAHS是睡眠呼吸障碍的最常见形式,其特点是睡眠时反复发生上气道塌陷导致经常觉醒,间歇低氧,睡眠片段化和睡眠质量下降。流行病学调查显示OSAHS的发病率较高,在我国其发病率是12%-13%。现普遍认为OSAHS是一种全身性疾病,所有导致鼻腔、咽腔和喉腔任何部位狭窄的原因都可以成为OSAHS的致病因素。OSAHS患者睡眠时反复发生上气道塌陷导致慢性间歇低氧,睡眠片段化,从而引起机体分子信号域的变化,如交感神经活性增强,氧化应激和炎症等,加重或导致患者出现白天嗜睡、脑卒中、高血压、冠状动脉粥样硬化性心脏病、心律失常、心力衰竭、肺动脉高压、支气管哮喘、胃食管反流、蛋白尿、糖尿病及胰岛素抵抗等全身多系统损伤,影响个人的生活和生命质量,给个人和社会带来沉重的经济负担。OSAHS的诊断“金标准”是PSG,除PSG外,便携式家庭用睡眠呼吸监测仪、上气道及食管压力测定、上气道三维影像学CT或MRI等其他多种监测技术可用于OSAHS的筛查和协助诊断。临床OSAHS的诊断主要依据病史和PSG监测结果,其诊断标准是7h睡眠中,呼吸暂停和低通气超过30次,或AHI5。对OSAHS患者进行积极的治疗,可以预防严重影响人体健康并发症的发生,改善治疗效果、提高生活质量、提前评估预后。多年来CPAP已成为OSAHS的首选治疗方法。不论发病机制如何,只要病人能够接受,CPAP均可治疗。
[Abstract]:OSAHS is the most common form of sleep apnea, characterized by recurrent upper airway collapse during sleep resulting in frequent arousal, intermittent hypoxia, sleep fragmentation and sleep quality decline. Epidemiological investigation shows that the incidence of OSAHS is high, and in our country, the incidence is 12-13. It is widely believed that OSAHS is a systemic disease. All the causes of narrow nasal, pharyngeal and laryngeal lumen can be the pathogenic factors of OSAHS. The recurrent collapse of upper airway in patients with OSAHS leads to chronic intermittent hypoxia and sleep fragmentation. Thus causing changes in molecular signal domains, such as increased sympathetic activity, oxidative stress and inflammation, exacerbating or leading to daytime sleepiness, stroke, hypertension, coronary atherosclerotic heart disease, arrhythmia, etc. Heart failure, pulmonary hypertension, bronchial asthma, gastroesophageal reflux, proteinuria, diabetes, insulin resistance, and other systemic multisystem injuries affect individual life and quality of life. The golden standard for the diagnosis of OSAHS is PSG. In addition to PSG, portable household sleep breathing monitors, upper airway and esophageal pressure measurements are used. Many other monitoring techniques, such as CT or MRI, can be used for screening and diagnosis of OSAHS. The diagnosis of clinical OSAHS is mainly based on the history and the results of PSG monitoring. The diagnostic criteria are more than 30 times of apnea and hypopnea or AHI 5 during 7 h sleep. The active treatment of OSAHS patients can prevent the occurrence of serious complications affecting human health, improve the therapeutic effect, improve the quality of life, and evaluate the prognosis ahead of time. Over the years, CPAP has become the preferred treatment for OSAHS. No matter what the pathogenesis, as long as the patient can accept CPAP can be treated.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

【共引文献】