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阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)是一种常见但较少被发现的因上气道狭窄或阻塞引起反复睡眠中断、微觉醒及白天嗜睡的综合征。其中大部分同时伴有肥胖、高血压、代谢综合症及其他心血管疾病,包括肥厚型心肌病(hypertrophic cardiomyopathy,HCM)。HCM是青少年猝死的最常见原因。近有研究发现HCM合并睡眠呼吸紊乱(sleep-disordered breathing,SDB)(包括阻塞性、中枢性及混合型睡眠呼吸暂停)的发生率在40%~80%左右。交感神经兴奋性增加、迷走神经兴奋性下降、心脏后负荷增加、胰岛素抵抗和血管内皮功能受损被认为是二者潜在联系。本文主要呈现HCM合并OSA的临床特征及研究现状,为进一步的研究及治疗提供方向。
Obstructive sleep apnea (OSA) is a common but seldom seen syndrome of recurrent sleep disruption, arousal, and daytime sleepiness caused by stenosis or obstruction of the upper airway. Most are accompanied by obesity, hypertension, metabolic syndrome and other cardiovascular diseases, including hypertrophic cardiomyopathy (HCM). HCM is the most common cause of sudden death in adolescents. Recent studies have found that HCM combined with sleep-disordered breathing (SDB) (including obstructive, central and mixed sleep apnea) incidence of 40% to 80%. Increased sympathetic excitability, decreased excitability of the vagus nerve, increased post-cardiac load, and impaired insulin resistance and endothelial function are thought to be the underlying link between the two. This article presents the clinical features and research status of HCM combined with OSA, providing direction for further research and treatment.