综述

低氧负荷在泛血管疾病风险评估中的研究进展

  • 吴静怡 ,
  • 施晟 ,
  • 张云云 ,
  • 崔小川
展开
  • 南京医科大学附属无锡人民医院全科医学科,江苏 无锡 214023
作者贡献/Authors’ Contributions吴静怡负责选题设计、 文献检索与整理、文献分析、论文撰写与修订及学术问题核查;施晟负责文献筛选、文献整理、归纳分析;张云云负责提出思路与概念框架、设计论文框架、对论文进行审阅与指导;崔小川负责提出研究总体思路、研究设计指导、对关键学术内容进行修改与把关、最终审阅、对文章负责及承担通信联络。
崔小川 E-mail:cuixiaochuan@njmu.edu.cn

收稿日期: 2025-06-05

  修回日期: 2025-08-29

  录用日期: 2025-09-16

  网络出版日期: 2026-08-19

基金资助

无锡市科技发展基金项目(K20221023)

版权

版权所有 © 2026 内科理论与实践编辑部

Research progress on hypoxic burden in the risk assessment of panvascular diseases

  • WU Jingyi ,
  • SHI Sheng ,
  • ZHANG Yunyun ,
  • CUI Xiaochuan
Expand
  • Department of General Medicine, Wuxi People's Hospital, Nanjing Medical University, Wuxi 214023, China

Received date: 2025-06-05

  Revised date: 2025-08-29

  Accepted date: 2025-09-16

  Online published: 2026-08-19

Copyright

Copyright © 2026 Journal of Internal Medicine Concepts & Practice. All rights reserved.

摘要

泛血管疾病指以动脉粥样硬化(atherosclerosis, AS)为特征的一组具有共同病因的血管疾病,可影响包括大脑、心脏、肾脏等重要器官及四肢在内的多个关键部位。间歇性低氧(intermittent hypoxia,IH)可参与泛血管疾病发生发展,并与部分不良临床结局相关。近年来,低氧负荷(hypoxic burden, HB)作为评估IH严重程度的新型指标,在泛血管疾病临床评估中的价值逐渐受到关注。本文就HB在心血管、脑血管、慢性肾脏病等泛血管疾病发生发展及临床不良结局评估中的应用价值相关研究进行综述。

本文引用格式

吴静怡 , 施晟 , 张云云 , 崔小川 . 低氧负荷在泛血管疾病风险评估中的研究进展[J]. 内科理论与实践, 2026 , 21(03) : 277 -283 . DOI: 10.16138/j.1673-6087.2026.03.15

Abstract

Panvascular diseases refer to a group of vasculopathies sharing common etiological factors, characterized by atherosclerosis (AS), which can affect multiple essential sites including vital organs such as the brain, heart, and kidneys, as well as the limbs. Intermittent hypoxia (IH) can readily exacerbate the progression of panvascular diseases. In recent years, hypoxic burden (HB) has emerged as a novel metric for assessing IH severity, garnering increasing attention for its clinical value in evaluating panvascular diseases. This review synthesizes current research on the application value of HB in evaluating the pathogenesis, progression, and adverse clinical outcomes of panvascular diseases, including cardiovascular, cerebrovascular, and chronic kidney diseases.

参考文献

[1] DiCaro MV, Lei K, Yee B, et al. The effects of obstructive sleep apnea on the cardiovascular system: a comprehensive review[J]. J Clin Med, 2024, 13(11): 3223.
[2] Li C, Huang Y, Chen J, et al. Retinal oculomics and risk of incident aortic aneurysm and aortic adverse events: a population-based cohort study[J]. Int J Surg, 2025, 111(3): 2478-2486.
[3] Roy TK, Secomb TW. Effects of impaired microvascular flow regulation on metabolism-perfusion matching and organ function[J]. Microcirculation, 2021, 28(3): e12673.
[4] Zhang Q, Zhao W, Li S, et al. Intermittent hypoxia conditioning: a potential multi-organ protective therapeutic strategy[J]. Int J Med Sci, 2023, 20(12): 1551-1561.
[5] Badran M, Gozal D. Intermittent hypoxia as a model of obstructive sleep apnea: present and future[J]. Sleep Med Clin, 2025, 20(1): 93-102.
[6] 马博, 叶志东, 刘鹏. 欧洲血管外科学会2023版《动脉粥样硬化性颈动脉和椎动脉疾病管理的临床实践指南》解读[J]. 中国普通外科杂志, 2023, 32(12): 1829-1841.
  Ma B, Ye ZD, Liu P. Interpretation of the European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease[J]. China J Gen Surg, 2023, 32(12): 1829-1841.
[7] Azarbarzin A, Sands SA, Stone KL, et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the osteoporotic fractures in men study and the sleep heart health study[J]. Eur Heart J, 2019, 40(14): 1149-1157.
[8] Esmaeili N, Labarca G, Hu WH, et al. Hypoxic burden based on automatically identified desaturations is associated with adverse health outcomes[J]. Ann Am Thorac Soc, 2023, 20(11): 1633-1641.
[9] Hu Y, Zhao Y, Li P, et al. Hypoxia and panvascular diseases: exploring the role of hypoxia-inducible factors in vascular smooth muscle cells under panvascular pathologies[J]. Sci Bull, 2023, 68(17): 1954-1974.
[10] 刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告2024》要点解读[J]. 临床心血管病杂志, 2025, 41(7): 492-511.
  Liu MB, He XY, Yang XH, et al. Interpretation of annual report on cardiovascular health and diseases in China 2024[J]. Journal of Clinical Cardiology, 2025, 41(7): 492-511.
[11] Zhang Z, Ai H, Yan M, et al. Prognostic effect of obstructive sleep apnea in acute coronary syndrome patients with heart failure[J]. Respir Med, 2024, 234: 107814.
[12] Wang X, Fan J, Guo R, et al. Association of obstructive sleep apnoea with cardiovascular events in women and men with acute coronary syndrome[J]. Eur Respir J, 2023, 61(1): 2201110.
[13] Azarbarzin A, Sands SA, Taranto-Montemurro L, et al. The sleep apnea-specific hypoxic burden predicts incident heart failure[J]. Chest, 2020, 158(2): 739-750.
[14] Trzepizur W, Blanchard M, Ganem T, et al. Sleep apnea-specific hypoxic burden, symptom subtypes, and risk of cardiovascular events and all-cause mortality[J]. Am J Respir Crit Care Med, 2022, 205(1): 108-117.
[15] Labarca G, Vena D, Hu WH, et al. Sleep apnea physiological burdens and cardiovascular morbidity and mortality[J]. Am J Respir Crit Care Med, 2023, 208(7): 802-813.
[16] Redline S, Azarbarzin A, Peker Y. Obstructive sleep apnea heterogeneity and cardiovascular disease[J]. Nat Rev Cardiol, 2023, 20(8): 560-573.
[17] Liu W, Zhang L, Liao W, et al. Unveiling the molecular and cellular links between obstructive sleep apnea-hypopnea syndrome and vascular aging[J]. Chin Med J, 2025, 138(2): 155-171.
[18] Huang B, Huang Y, Zhai M, et al. Association of hypoxic burden metrics with cardiovascular outcomes in heart failure and sleep-disordered breathing[J]. ESC Heart Fail, 2023, 10(6): 3504-3514.
[19] Li YE, Ren J. Association between obstructive sleep apnea and cardiovascular diseases[J]. Acta Biochim Biophys Sin, 2022, 54(7): 882-892.
[20] Steiner S, Schueller PO, Schulze V, et al. Occurrence of coronary collateral vessels in patients with sleep apnea and total coronary occlusion[J]. Chest, 2010, 137(3): 516-520.
[21] Allahwala UK, Cistulli PA, Ekmejian A, et al. Relation of obstructive sleep apnea in patients with a coronary chronic total occlusion to coronary collaterals and mortality[J]. Am J Cardiol, 2021, 148: 30-35.
[22] Zhang H, Liu H, Jiao Y, et al. Association between sleep apnea-specific hypoxic burden and severity of coronary artery disease[J]. Sleep Breath, 2024, 28(3): 1293-1301.
[23] Pinilla L, Esmaeili N, Labarca G, et al. Hypoxic burden to guide CPAP treatment allocation in patients with obstructive sleep apnea: a post hoc study of the ISAACC trial[J]. Eur Respir J, 2023, 62(6): 2300828.
[24] Kundel V, Devarakonda K, Khan S, et al. Exploring the relationship between sleep apnea, myocardial infarct size, and coronary collaterals in acute myocardial infarction: a multidisciplinary study[J]. Nat Sci Sleep, 2025, 17: 27-42.
[25] Onuki K, Ikeda A, Muraki I, et al. Nocturnal intermittent hypoxia and the risk of cardiovascular disease among Japanese populations: the circulatory risk in communities study (CIRCS)[J]. J Atheroscler Thromb, 2023, 30(9): 1276-1287.
[26] Blanchard M, Gervès-Pinquié C, Feuilloy M, et al. Hypoxic burden and heart rate variability predict stroke incidence in sleep apnoea[J]. Eur Respir J, 2021, 57(3): 2004022.
[27] Bodard S, Denis L, Hingot V, et al. Ultrasound localization microscopy of the human kidney allograft on a clinical ultrasound scanner[J]. Kidney Int, 2023, 103(5): 930-935.
[28] Jackson CL, Umesi C, Gaston SA, et al. Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the multi-ethnic study of atherosclerosis[J]. Thorax, 2021, 76(7): 704-713.
[29] Berisha DE, Rizvi B, Chappel-Farley MG, et al. Association of hypoxemia due to obstructive sleep apnea with white matter hyperintensities and temporal lobe changes in older adults[J]. Neurology, 2025, 104(11): e213639.
[30] Groh J, Simons M. White matter aging and its impact on brain function[J]. Neuron, 2025, 113(1): 127-139.
[31] Hajipour M, Hu WH, Esmaeili N, et al. Sleep apnea physiological burdens and markers of white matter injury: the multi-ethnic study of atherosclerosis[J]. J Clin Sleep Med, 2025, 21(3): 457-466.
[32] Huang X, Zhang Z, Lan X, et al. The association between hypoxic burden and the risk of cognitive impairment in patients with obstructive sleep apnea[J]. Sleep, 2025, 48(3): zsae269.
[33] Yook S, Park HR, Seo D, et al. Obstructive sleep apnea subtyping based on apnea and hypopnea specific hypoxic burden is associated with brain aging and cardiometabolic syndrome[J]. Comput Biol Med, 2025, 185: 109604.
[34] Cohen O, Kundel V, Barbé F, et al. The great controversy of obstructive sleep apnea treatment for cardiovascular risk benefit: advancing the science through expert consensus: an official American thoracic society workshop report[J]. Ann Am Thorac Soc, 2025, 22(1): 1-22.
文章导航

/