开角型青光眼患者阻塞性睡眠呼吸暂停的风险：一项基于人群的队列研究

文献信息

中文摘要

要点： 在这项回顾性基于人群的队列研究中，与明尼苏达州奥姆斯特德县一般人群中匹配的对照者相比，开角型青光眼患者更可能发生阻塞性睡眠呼吸暂停。
目的： 探讨开角型青光眼（OAG）患者发生阻塞性睡眠呼吸暂停（OSA）的风险，并与一般人群中匹配对照者的OSA风险进行比较。
患者与方法： 这是一项回顾性基于人群的病例对照研究，比较1980年1月1日至2018年12月31日期间明尼苏达州奥姆斯特德县确诊OAG患者（病例）的OSA发生率与无OAG的匹配患者（对照）的OSA发生率。患者通过罗切斯特流行病学项目识别。查阅病历以确认OAG诊断。OSA诊断基于睡眠研究数据和多导睡眠监测参数。采用Kaplan-Meier法估计OSA的累积概率。
结果： 本队列共有7,000例患者：3,500例在任何时间点确诊OAG的病例患者，以及3,500例无OAG的匹配对照者，所有OAG和OSA诊断均经人工确认。在索引日期之前，病例与对照之间的OSA频率无统计学显著差异（P=0.52）。有371例（12.5%）病例在青光眼诊断后发生OSA，而297例（10.2%）患者在索引日期后被诊断为OSA（P=0.0068）。OAG诊断后诊断为OSA的多变量风险比为1.17（P=0.047，95% CI：1.00，1.36）。OAG诊断后10年OSA绝对风险为12.5%，且OSA风险随时间增加。
结论： 在这项基于人群的研究中，与无OAG的患者相比，OAG患者更可能被诊断为OSA，提示可能存在关联，或可支持提高临床警惕性。

英文摘要

PRECIS: In this retrospective population-based cohort study, patients with open-angle glaucoma were more likely to develop obstructive sleep apnea than matched controls from the general population of Olmsted County, Minnesota.
PURPOSE: To investigate the risk of obstructive sleep apnea (OSA) in patients with open-angle glaucoma (OAG) compared to the risk of OSA in matched controls from a general population.
PATIENTS AND METHODS: Retrospective population-based case-control study comparing the incidence of OSA with a diagnosis of OAG (cases) to the incidence of OSA in matched patients without OAG (controls) from Olmsted County, Minnesota between January 1, 1980 and December 31, 2018. Patients were identified using the Rochester Epidemiology Project. Medical records were reviewed to confirm OAG diagnoses. OSA diagnoses were based on sleep study data and polysomnography parameters. Cumulative probability of OSA was estimated using the Kaplan-Meier method.
RESULTS: This cohort had 7,000 patients: 3,500 case patients with OAG diagnosed at any time point, and 3,500 matched control subjects without OAG, with all OAG and OSA diagnoses manually confirmed. There was no statistically significant difference of OSA frequency prior to index date in cases versus controls (P=0.52). There were 371 (12.5%) cases who developed OSA after glaucoma diagnosis compared to 297 (10.2%) patients who were diagnosed with OSA after the index date (P=0.0068). The multivariate hazard ratio for diagnosis of OSA after OAG diagnosis was 1.17 (P=0.047, 95% CI: 1.00, 1.36). The 10-year absolute risk of OSA after OAG diagnosis was 12.5%, and risk of OSA increased with time.
CONCLUSION: In this population-based study, patients with OAG were more likely to be diagnosed with OSA compared to patients without OAG, suggesting a possible association that may justify increased clinical awareness.