Vascular effects of intermittent hypoxia.
Vascular effects of intermittent hypoxia.
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DOI：
10.1093/ilar.50.3.282
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发表时间：
2009
期刊：
影响因子：
2.5
通讯作者：
Kanagy NL
中科院分区：
文献类型：
--
作者：
Kanagy NL
阻塞性睡眠呼吸暂停的特征是睡眠期间反复出现上呼吸道阻塞，影响5%至20%的人口。流行病学研究表明，睡眠呼吸暂停和相关的间歇性低氧血症增加了高血压和血管疾病的风险，但这些影响的机制尚不完全清楚。本文综述了间歇性缺氧（IH）啮齿动物模型的结果，并将其与观察到的睡眠呼吸暂停的血流动力学和血管后果。这些动物研究表明，在没有任何其他合并症的情况下，IH暴露会导致高血压、内皮功能障碍和收缩肌敏感性增强，所有这些至少部分是由于血管氧化应激增加。动物研究已经使用了各种暴露范式来研究间歇性缺氧，这些不同的暴露方案可能会导致低碳酸血症或高碳酸血症-或维持eucapnia-伴随血浆pH值的改变。似乎这些不同的动脉血气分布可能导致不同的结果，但这些差异的影响仍在研究中。总体而言，啮齿类动物研究已清楚地表明，间歇性缺氧对血管和血流动力学的影响为治疗临床睡眠呼吸暂停提供了强有力的理论依据，以预防由此导致的心血管发病率和死亡率。
Obstructive sleep apnea is characterized by repeated upper airway obstruction during sleep and affects between 5% and 20% of the population. Epidemiological studies reveal that sleep apnea and associated intermittent hypoxemia increase the risk for hypertension and vascular disease but the mechanisms underlying these effects are incompletely understood. This review reports the results of rodent models of intermittent hypoxia (IH) and relates them to the observed hemodynamic and vascular consequences of sleep apnea. These animal studies have demonstrated that IH exposure in the absence of any other comorbidity causes hypertension, endothelial dysfunction, and augmented constrictor sensitivity, all due at least in part to increased vascular oxidative stress. Animal studies have used a variety of exposure paradigms to study intermittent hypoxia and these different exposure protocols can cause hypocapnia or hypercapnia—or maintain eucapnia—with accompanying alterations in plasma pH. It appears that these different profiles of arterial blood gases can lead to divergent results but the impact of these differences is still being investigated. Overall, the studies in rodents have clearly demonstrated that the vascular and hemodynamic impact of intermittent hypoxia provides a strong rationale for treating clinical sleep apnea to prevent the resulting cardiovascular morbidity and mortality.
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