- 期刊
阻塞性睡眠呼吸中止症候群與腦中風
Obstructive Sleep Apnea-Hypopnea Syndrome and Stroke
摘要
阻塞性睡眠呼吸中止症候群是在睡覺時上呼吸道發生反覆性的塌陷，因而堵住呼吸道，造成呼吸氣流減小。臨床症狀包括打鼾及白天嗜睡，夜間胸悶、窒息或嗆醒。在學童方面會造成上課注意力不集中、學習障礙，甚至表現好動，易被誤診爲過動兒。併發症有高血壓、心血管疾病、心肌梗塞、心衰竭及腦中風等。標準的診斷方式是根據臨床症狀及夜間多頻道睡眠呼吸生理檢查。治療阻塞性睡眠呼吸中止症候群的方式眾多，針對不同的情形，應選擇不同的治療方式。經由越來越多的臨床報告，對於阻塞性睡眠呼吸中止症候群是腦中風獨立危險的爭議，也被確定。所有阻塞性睡眠呼吸中止症候群造成心血管疾病的機轉，也是造成腦中風的病理機轉。本篇文章對阻塞性睡眠呼吸中止症候群的病理生理機轉、臨床症狀、併發症、診斷及治療方式做一個描述，並對阻塞性睡眠呼吸中止症候群與腦中風的關係做一個綜合的探討。
並列摘要
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive episodes of upper airway obstruction that occur during sleep. The symptoms of OSAHS include habitual snoring and daytime sleepiness with brings accident events. Children of OSAHS have the symptoms of learning problem with impaired school performance and hyperactivity, which may be misdiagnosed as attention deficit/hyperactivity disorder. The complications of OSAHS are known as hypertension, cardiovascular and cerebrovascular disease, metabolic syndrome, cognitive dysfunction and psychiatric disorders. The diagnosis of OSAHS is based on clinical symptoms and polysomnography study. Treatment of OSAHS should be tailored to individual condition. Since more and more clinical studies were reported, the debate of OSAHS as an independent risk factor for stroke is confirmed. Mechanisms, which OSAHS inducing cardiovascular disease, are the same pathogenicc pathway for stroke. This article described the pathophysiology, clinical symptoms, complication, diagnosis and treatment of OSAHS, and the association between OSAHS and stroke were reviewed.