阻塞性睡眠呼吸暂停低通气综合征与 肺动脉高压的关系
The Association between Obstructive Sleep Apnea-Hypopnea Syndrome and Pulmonary Hypertension
摘要: 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)作为一种高患病率的睡眠呼吸疾病，其与肺动脉高压(PH)的共病现象已成为呼吸与心血管交叉领域的研究热点。流行病学数据显示，OSAHS显著增加了PH的发病风险，二者的并存往往预示着更差的临床结局。本文系统综述了OSAHS相关PH的最新研究进展，深入解析间歇性缺氧、胸腔内压剧烈波动、交感神经过度激活及系统性炎症等核心机制，阐明了上述因素如何通过协同调控肺血管张力与促进血管重塑，最终导致PH的发生发展。文章进一步探讨了该共病在儿童、唐氏综合征及重叠综合征等特殊人群中的临床异质性，并总结了当前用于PH风险识别的筛查策略与诊断流程，旨在为临床早期干预及制定循证诊疗策略提供理论参考。
Abstract: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is frequently comorbid with pulmonary hypertension (PH), posing a significant clinical burden at the cardio-respiratory interface. Epidemiological evidence links OSAHS to adverse cardiovascular outcomes, yet the underlying mechanisms remain complex. This review synthesizes recent advances in OSAHS-associated PH, focusing on core pathophysiological drivers including intermittent hypoxia, exaggerated intrathoracic pressure swings, sympathetic overactivation, and systemic inflammation. We elucidate how these factors synergistically induce endothelial dysfunction, promote pulmonary vasoconstriction, and drive vascular remodeling, ultimately elevating pulmonary arterial pressure. Special attention is given to clinical heterogeneity across high-risk populations, such as pediatric patients, individuals with Down syndrome, and those with overlap syndrome. Furthermore, we evaluate current screening strategies and diagnostic workflows, highlighting the utility of hypoxia burden metrics and echocardiography for early risk stratification. By integrating mechanistic insights with clinical evidence, this review aims to refine early intervention strategies and guide personalized management for OSAHS-related PH.
文章引用：郭俊, 安璐瑶. 阻塞性睡眠呼吸暂停低通气综合征与 肺动脉高压的关系[J]. 临床医学进展, 2026, 16(6): 2520-2530. https://doi.org/10.12677/acm.2026.1662475

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