{"title":"卵圆孔未闭（PFO）加重中度至重度阻塞性睡眠呼吸暂停（OSA）患者的间歇性缺氧。","authors":"Yidi Lv, Litao Ruan, Aihong Guo, Zhaoying Lu, Guoxun Zhang, Xinjun Lei","doi":"10.1007/s11325-025-03337-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Both obstructive sleep apnea (OSA)and patent foramen ovale (PFO) can lead to changes in blood oxygen. However, it is unclear whether PFO exacerbates the blood oxygen indicators of OSA.</p><p><strong>Methods: </strong>This case series study included patients who underwent contrast-enhanced transcranial Doppler (c-TCD) and polysomnography (PSG examination) between January 2017 to December 2023 at the Third Affiliated Hospital of Yan'an University. Based on c-TCD and PSG results, patients were categorized into two groups: OSA and PFO double-positive group (OSA + PFO), OSA single-positive group (OSA). Furthermore, both the OSA + PFO and OSA groups were further subdivided into mild (5 times/hour ≤ AHI < 15 times/hour), moderate (15 times/hour ≤ AHI < 30 times/hour) and severe (AHI ≥ 30 times/hour) groups according to their apnea-hypopnea index (AHI). This study compared the minimum oxygen saturation, oxygen desaturation index (ODI), the percentage of cumulative time with oxygen saturation < 90% in total sleep time (T90) among all groups.</p><p><strong>Results: </strong>A total of 509 patients were included (386 males,75.83%; 123females,24.17%), with an average age of 56.76 ± 10.23 years. The study cohort included 97 OSA + PFO cases (55.67% moderate to severe) and 412 OSA cases (63.35% moderate to severe). No significant differences were observed in minimum oxygen saturation (75.97 ± 12.70% vs. 76.34 ± 12.67%, respectively, P =0.607) and ODI (32.99 ± 24.16% vs. 34.31 ± 23.59%, respectively, P =0.173) between the OSA group and the OSA + PFO group. Similarly, no significant differences were found in T90 (14.20 ± 20.50% vs. 16.69 ± 21.62%, respectively, P =0.075) between the OSA group and the OSA + PFO group. However, the T90 values were significantly higher in the moderate-severe OSA + PFO group compared to the moderate-severe OSA group (26.21 ± 22.97% vs.18.68 ± 22.02%, respectively, P < 0.05).</p><p><strong>Conclusions: </strong>Although PFO has no significant effect on minimum oxygen saturation and ODI, PFO further aggravates intermittent hypoxia in patients with moderate to severe OSA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"186"},"PeriodicalIF":2.1000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081481/pdf/","citationCount":"0","resultStr":"{\"title\":\"Patent foramen ovale (PFO) exacerbates intermittent hypoxia in moderate-to-severe obstructive sleep apnea (OSA) patients.\",\"authors\":\"Yidi Lv, Litao Ruan, Aihong Guo, Zhaoying Lu, Guoxun Zhang, Xinjun Lei\",\"doi\":\"10.1007/s11325-025-03337-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Both obstructive sleep apnea (OSA)and patent foramen ovale (PFO) can lead to changes in blood oxygen. However, it is unclear whether PFO exacerbates the blood oxygen indicators of OSA.</p><p><strong>Methods: </strong>This case series study included patients who underwent contrast-enhanced transcranial Doppler (c-TCD) and polysomnography (PSG examination) between January 2017 to December 2023 at the Third Affiliated Hospital of Yan'an University. Based on c-TCD and PSG results, patients were categorized into two groups: OSA and PFO double-positive group (OSA + PFO), OSA single-positive group (OSA). Furthermore, both the OSA + PFO and OSA groups were further subdivided into mild (5 times/hour ≤ AHI < 15 times/hour), moderate (15 times/hour ≤ AHI < 30 times/hour) and severe (AHI ≥ 30 times/hour) groups according to their apnea-hypopnea index (AHI). This study compared the minimum oxygen saturation, oxygen desaturation index (ODI), the percentage of cumulative time with oxygen saturation < 90% in total sleep time (T90) among all groups.</p><p><strong>Results: </strong>A total of 509 patients were included (386 males,75.83%; 123females,24.17%), with an average age of 56.76 ± 10.23 years. The study cohort included 97 OSA + PFO cases (55.67% moderate to severe) and 412 OSA cases (63.35% moderate to severe). No significant differences were observed in minimum oxygen saturation (75.97 ± 12.70% vs. 76.34 ± 12.67%, respectively, P =0.607) and ODI (32.99 ± 24.16% vs. 34.31 ± 23.59%, respectively, P =0.173) between the OSA group and the OSA + PFO group. Similarly, no significant differences were found in T90 (14.20 ± 20.50% vs. 16.69 ± 21.62%, respectively, P =0.075) between the OSA group and the OSA + PFO group. However, the T90 values were significantly higher in the moderate-severe OSA + PFO group compared to the moderate-severe OSA group (26.21 ± 22.97% vs.18.68 ± 22.02%, respectively, P < 0.05).</p><p><strong>Conclusions: </strong>Although PFO has no significant effect on minimum oxygen saturation and ODI, PFO further aggravates intermittent hypoxia in patients with moderate to severe OSA.</p>\",\"PeriodicalId\":21862,\"journal\":{\"name\":\"Sleep and Breathing\",\"volume\":\"29 2\",\"pages\":\"186\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081481/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep and Breathing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11325-025-03337-9\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep and Breathing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11325-025-03337-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：阻塞性睡眠呼吸暂停（OSA）和卵圆孔未闭（PFO）均可引起血氧变化。然而，PFO是否会加重OSA的血氧指标尚不清楚。方法：本病例系列研究纳入2017年1月至2023年12月在延安大学第三附属医院接受经颅多普勒造影（c-TCD）和多导睡眠图（PSG）检查的患者。根据c-TCD和PSG结果将患者分为两组：OSA和PFO双阳性组（OSA + PFO）和OSA单阳性组（OSA）。此外，OSA + PFO组和OSA组进一步细分为轻度（5次/小时≤AHI）。结果：共纳入509例患者(男性386例，75.83%；女性123例，占24.17%)，平均年龄56.76±10.23岁。研究队列包括97例OSA + PFO（55.67%中至重度）和412例OSA（63.35%中至重度）。OSA组与OSA + PFO组最低血氧饱和度（75.97±12.70% vs. 76.34±12.67%,P =0.607）、ODI（32.99±24.16% vs. 34.31±23.59%,P =0.173）差异无统计学意义。同样，OSA组与OSA + PFO组T90（14.20±20.50% vs 16.69±21.62%,P =0.075）无显著差异。但中重度OSA + PFO组T90值明显高于中重度OSA组（分别为26.21±22.97%和18.68±22.02%）P结论：PFO虽对最低血氧饱和度和ODI无显著影响，但PFO进一步加重了中重度OSA患者的间歇性缺氧。
Purpose: Both obstructive sleep apnea (OSA)and patent foramen ovale (PFO) can lead to changes in blood oxygen. However, it is unclear whether PFO exacerbates the blood oxygen indicators of OSA.
Methods: This case series study included patients who underwent contrast-enhanced transcranial Doppler (c-TCD) and polysomnography (PSG examination) between January 2017 to December 2023 at the Third Affiliated Hospital of Yan'an University. Based on c-TCD and PSG results, patients were categorized into two groups: OSA and PFO double-positive group (OSA + PFO), OSA single-positive group (OSA). Furthermore, both the OSA + PFO and OSA groups were further subdivided into mild (5 times/hour ≤ AHI < 15 times/hour), moderate (15 times/hour ≤ AHI < 30 times/hour) and severe (AHI ≥ 30 times/hour) groups according to their apnea-hypopnea index (AHI). This study compared the minimum oxygen saturation, oxygen desaturation index (ODI), the percentage of cumulative time with oxygen saturation < 90% in total sleep time (T90) among all groups.
Results: A total of 509 patients were included (386 males,75.83%; 123females,24.17%), with an average age of 56.76 ± 10.23 years. The study cohort included 97 OSA + PFO cases (55.67% moderate to severe) and 412 OSA cases (63.35% moderate to severe). No significant differences were observed in minimum oxygen saturation (75.97 ± 12.70% vs. 76.34 ± 12.67%, respectively, P =0.607) and ODI (32.99 ± 24.16% vs. 34.31 ± 23.59%, respectively, P =0.173) between the OSA group and the OSA + PFO group. Similarly, no significant differences were found in T90 (14.20 ± 20.50% vs. 16.69 ± 21.62%, respectively, P =0.075) between the OSA group and the OSA + PFO group. However, the T90 values were significantly higher in the moderate-severe OSA + PFO group compared to the moderate-severe OSA group (26.21 ± 22.97% vs.18.68 ± 22.02%, respectively, P < 0.05).
Conclusions: Although PFO has no significant effect on minimum oxygen saturation and ODI, PFO further aggravates intermittent hypoxia in patients with moderate to severe OSA.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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