阻塞性睡眠呼吸暂停对心脏舒张功能障碍影响的Meta分析

田海燕; 王杨淦

doi:10.14188/j.1671-8852.2026.0808

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阻塞性睡眠呼吸暂停对心脏舒张功能障碍影响的Meta分析

更新时间：2026-10-10

- 阻塞性睡眠呼吸暂停对心脏舒张功能障碍影响的Meta分析
- Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis
- 武汉大学学报（医学版） 2026年页码：1-9
- 作者机构：
  
  武汉大学中南医院老年医学科湖北武汉 430071
- 作者简介：
  
  田海燕，女，2001—，医学硕士生，主要从事心力衰竭方面的临床研究，E⁃mail：thy011122@163.com。
  王杨淦，E⁃mail：wb000813@whu.edu.cn。
- 基金信息：
  
  湖北省重点研发计划项目(2022BCA002)
- DOI：10.14188/j.1671-8852.2026.0808
  中图分类号： R563.8
- 收稿：2026-05-16，
  
  网络首发：2026-10-10，
- 稿件说明：
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田海燕, 王杨淦. 阻塞性睡眠呼吸暂停对心脏舒张功能障碍影响的Meta分析[J/OL]. 武汉大学学报（医学版）, 2026,1-9.

TIAN Haiyan, WANG Yanggan. Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis[J/OL]. Medical Journal of Wuhan University, 2026, 1-9.
田海燕, 王杨淦. 阻塞性睡眠呼吸暂停对心脏舒张功能障碍影响的Meta分析[J/OL]. 武汉大学学报（医学版）, 2026,1-9. DOI： 10.14188/j.1671-8852.2026.0808.

TIAN Haiyan, WANG Yanggan. Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis[J/OL]. Medical Journal of Wuhan University, 2026, 1-9. DOI： 10.14188/j.1671-8852.2026.0808.

摘要

目的

系统评价阻塞性睡眠呼吸暂停（OSA）与心脏舒张功能障碍相关超声心动图指标的关系。

方法

检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方和维普数据库，检索时限为建库至2026年5月16日。采用纽卡斯尔⁃渥太华量表评价研究质量，应用固定或随机效应模型合并均数差（

），并进行亚组分析、逐一剔除敏感性分析及Begg秩相关检验。

结果

纳入21项成人观察性研究，共2 612例。OSA组左心室射血分数与对照组差异无统计学意义（

=-0.53，95%

：-1.31~0.24），但左心室质量指数、左心房容积指数、二尖瓣舒张早期血流减速时间、等容舒张时间、E/e′及收缩期肺动脉压升高，E/A降低（均

0.05）。逐一剔除研究后效应方向未变，其中左心室质量指数、E/A、等容舒张时间及E/e′结果最稳定；Begg检验未见明显发表偏倚。

结论

OSA与左心室肥厚、左心房重构、舒张松弛受损及充盈压升高相关，心脏舒张功能异常可能早于左心室射血分数下降出现。

Abstract

Objective

To systematically review the association between obstructive sleep apnea (OSA) and echocardiographic indices of cardiac diastolic dysfunction.

Methods

PubMed

Embase

Web of Science

the Cochrane Library

CNKI

Wanfang

and VIP were searched from inception to May 16

2026. Study quality was assessed using the Newcastle⁃Ottawa Scale. Mean differences (

s) were pooled using fixed⁃ or random⁃effects models. Subgroup analyses

leave⁃one⁃out sensitivity analyses

and Begg rank correlation tests were performed.

Results

Twenty⁃one adult observational studies involving 2 612 participants were included. Left ventricular ejection fraction did not differ significantly between the OSA and control groups (

=-0.53

95%

: -1.31 to 0.24). In contrast

OSA was associated with higher left ventricular mass index

left atrial volume index

deceleration time

isovolumic relaxation time

E/e′ ratio

and systolic pulmonary artery pressure

together with a lower E/A ratio (all

0.05). Leave⁃one⁃out analyses did not alter the direction of any pooled effect; the results for left ventricular mass index

E/A ratio

isovolumic relaxation time

and E/e′ ratio

were the most robust. Begg tests indicated no significant publication bias.

Conclusion

OSA is associated with cardiac structural remodeling

impaired ventricular relaxation

and elevated filling pressure. Diastolic abnormalities may occur before a detectable reduction in left ventricular ejection fraction.

关键词

Keywords

references

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