OBSTRUCTIVE SLEEP APNEA
阻塞性睡眠呼吸暂停
DEFINITION
Obstructive sleep apnea (OSA) is a chronic condition of cyclic obstruction of the upper airway during sleep, combined with associated symptoms or signs of disturbed sleep, the most common being excessive daytime sleepiness and loud snoring. A frequency of at least five obstructive events per hour of sleep is a minimal criterion for diagnosing OSA in adults, although a higher frequency of obstructive events is more consistently correlated with an increased risk of cardiovascular and neurocognitive disorders.
定义
阻塞性睡眠呼吸暂停(OSA)是一种慢性阻塞性睡眠障碍,表现为睡眠时出现周期性上呼吸道阻塞,伴随着睡眠紊乱的症状或体征,其中最常见的是白天嗜睡、鼾声响亮。诊断成人OSA的最低标准是每晚睡眠过程中阻塞性事件发作≥5次/小时,较高频率的阻塞性障碍事件被认为与心血管和神经认知障碍的风险增加密切相关。
PROGNOSIS
Population studies show an increased risk of all-cause and cerebrovascular and coronary mortality in patients with untreated severe OSA and in patients with AHIs of 30 or more per hour, independent of other major risk factors. When patients with severe OSA are prescribed CPAP (Continuos Positive Airway Pressure), 5-year survival rates are significantly higher in those with good CPAP adherence (>6 hours/day) than in those with poor adherence. Like other patients with sleep disorders, patients with OSA are at greater risk for morbidity and mortality from motor vehicle accidents compared with drivers without OSA.
预后
人口研究表明,独立于其他主要危险因素,未经治疗的重度OSA患者和AHIs指数大于等于30的患者,其全因死亡率以及脑血管和冠心病死亡率风险增加。当重度OSA患者使用CPAP(持续气道正压通气)时,依从性好的患者5年生存率显著高于依从性差的患者,前者是指使用CPAP> 6小时/天。类似于其他患有睡眠障碍的患者,患OSA的司机相比于不患OSA的司机,车祸的发生率和死亡率更高。
英文节选自Chapter 100 of cecil medicine,25th edition;中文为撰稿者自译,不当之处望批评指正。图片来源于网络。)
【本期语言点总结】
1.symptom 症状,cf. Syndrome 综合征
2.Sign 体征
3.Cardiovascular [ˌkɑ:diəʊˈvæskjələ(r)] adj. 心血管的
Cardio- (heart) eg. Myocardial 心肌的
4.Neurocongnitive
Neuro- (nerve) eg.neuropathy 神经病
5.Cerebrovascular
Cerebr/o- (cerebrum大脑) eg。 Cerebrospinal fluid 脑脊液
Cerebell/o- (cerebellum [ˌserəˈbeləm] 小脑) eg。Cerebellar 小脑
encephal/o- (brain )Encephalitis [enˌsefəˈlaɪtəs] 脑炎
英语单词 cerebrum 和 brain 都表示“大脑”,区别在于: brain 来自古英语,是“大脑”的通俗说法;而 cerebrum 来自拉丁语,是“大脑”的专业说法,一般用于医学等专业领域。
6.CPAP (Continuos Positive Airway Pressure) 持续气道正压通气
Positive 阳性
Negative 阴性
7.adherence[ədˈhɪərəns] n.依附;依从性
词根: here =stick,表示"粘附"
8.morbidity and mortality 发病率和死亡率
一些流行病学常用概念:
发病率 ( incidence rate)
患病率 ( prevalence rate)
病死率 ( fatality rate)
散发 ( sporadic)
流行 ( epidemic)
暴发 ( outbreak)
易感人群(population at risk)
Bgm-drenched
撰稿讲解:福建医科大学 淑铉铉铉