阻塞性睡眠呼吸暂停综合征人群视网膜血管病变的流行病学队列研究

Obstructive sleep apnea syndrome (OSAS) is a major source of illness causing chronic diseases such as cardiovascular disease. Our previous clinical studies indicate that OSAS is associated with retinal vascular lesions. Retinal vessels are the only vessels that can be directly observed by non-traumatic method and have similar anatomical, physiological and embryonic development characteristics in the coronary and cerebrovascular systems, retinal vascular abnormalities can occur before cardiovascular disease and predict the occurrence, course and prognosis of cardiovascular disease. Therefore, this project by prospective cohort study, for hypoxia-sensitive retina, using digital fundus photography analysis technology and enhanced depth imaging optical coherence tomography on the quantitative analysis of retinal vessels, explores the occurrence and development of correlation of OSAS and retinal vascular injury. Specifically, starting from OSAS features as chronic intermittent hypoxia and reoxygenation way, we will focus on hyperfuction of sympathetic nerve, inflammation, oxidative stress and other related research to find if there has common mechanism between OSAS and retinal vessels. Exploring pathogenesis of organ damage induced by OSAS will be helpful to establishing prevention and new method treating OSAS and its cardiovascular disease.

阻塞性睡眠呼吸暂停综合征（OSAS）是引发心血管等慢性疾病的源头性重大疾病。项目组前期临床研究发现，OSAS与视网膜血管病变相关，且视网膜血管是唯一非创伤性可直接观察的血管，与冠脉系统、脑血管系统有类似的解剖、生理和胚胎发育特征，视网膜血管异常可出现于心血管疾病之前，预测心血管疾病的发生、病程及预后。因此，本项目采用前瞻性队列研究设计，针对缺氧敏感的视网膜，首次引入数码眼底照相分析技术、增强深部成像的光学相干断层扫描技术，进行视网膜血管定性定量分析，推断OSAS与视网膜血管病变发生发展的因果关系；揭示OSAS视网膜微小血管病变与心脏大血管病变的关系；从OSAS特征性慢性间断低氧入手，分别在交感神经兴奋、炎症、氧化应激等相关通路方面探索损伤发生机制，为建立OSAS心血管损伤早期防控及新的有效治疗方法提供理论依据。

阻塞性睡眠呼吸暂停综合征（OSAS）是引发心血管等慢性疾病的源头性重大疾病。而视网膜血管是唯一非创伤性可直接观察的血管，与冠脉系统、脑血管系统有类似的解剖、生理和胚胎发育特征，视网膜血管异常可出现于心血管疾病之前，预测心血管疾病的发生、病程及预后。因此，本项目重点研究了：光学相干体层摄影术诊断OSAS患者视网膜微血管病变,发现极重度OSAS患者的视网膜微血管密度显著降低；低氧负荷诊断OSAS患者视网膜血管病变；阻塞性睡眠呼吸暂停综合征对视网膜血管影响的前瞻性研究；上气道持续正压通气对阻塞性睡眠呼吸暂停综合征患者睡眠结构的影响，是否通过睡眠结构的改善进而降低、消除OSAS造成的视网膜血管损伤；OSAS患者特异性口腔菌群特征分析，探讨菌群在OSAS导致心血管疾病机制中的作用。为推断OSAS与视网膜血管病变发生发展的因果关系，探索损伤发生机制，建立OSAS心血管损伤早期防控及新的有效治疗方法提供理论依据。

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