Atherosclerosis Clinical Trial
Official title:
The Influence of Mandibular Advancement Device Treating OSAHS on Primary Prevention of Ischemic Stroke
1. The purpose of this study is to detect the differences of carotid atherosclerosis
severity between patients with or without OSAHS(Obstructive Sleep Apnea and Hypopnea
Syndrome) in a cross-sectional study in a large sample.
2. Then a longitudinal control study is conducted to observe the progress of the carotid
atherosclerosis by vascular ultrasonography and the occurrence of cerebrovascular events
after the intervention of the oral appliance for treating OSAHS,and finally explore the
feasibility of using oral appliance to treat OSAHS in primary prevention of ischemic
stroke.
1. the relevance of OSAHS and carotid atherosclerosis Patients are distributed
questionnaire and recruited from neurology clinic,vascular ultrasonography clinic of
Xuanwu Hospital if they match the inclusion criteria. After initial screening, carotid
atherosclerosis patients with skeptical OSAHS are sent to sleep center for
polysomnography examination to determine the severity of OSAHS. At least 50 patients for
mild, moderate, severe OSAHS each are recruited for OSAHS Group. At least 100 patients
without snoring from questionnaire and without OSAHS after PSG screening are recruited
for non OSAHS Group. Vascular ultrasonography examination for carotid are done for the
two groups. Data of carotid vascular plaque from two groups are collected. Statistics
are done to detect differences of carotid atherosclerosis severity between patients with
and without OSAHS, also the severity of OSAHS.
2. the relevance of the progress of carotid atherosclerosis and oral appliances
intervention for treating OSAHS All carotid atherosclerosis patients with OSAHS are from
patients of the first study. If they consent the treatment of oral appliances, they are
recruited into this second study. At least 100 patients are recruited. They are divided
into 2 groups by randomized block design by Evidence-based Medicine Center of Xuanwu
Hospital. One group is oral appliance intervention group, the other group is no
intervention group. The intervention group patients accept oral appliance treatment, and
no intervention group patients do not accept OSAHS treatment. The two groups both accept
anti-hypertension treatment or anti-diabetes treatment, or anti-hyperlipidemia treatment
according to their own situation in neurology clinic.
At timepoint of initial time, one month after oral appliance treatment, one and a half year
after oral appliance treatment, the intervention group should accept PSG(Polysomnography)
examination to monitor the treatment of OSAHS.
At timepoint of initial time, one month after oral appliance treatment, one and a half year
after oral appliance treatment, the two groups should accept breath holding test to monitor
the cerebral vascular reserve.
At timepoint of initial time, one and a half year after oral appliance treatment, the two
groups should accept carotid vascular ultrasonography examination to monitor the progress of
carotid atherosclerosis.
Cerebrovascular events and death are recorded from initial time. Statistics are done to
detect the influence of treatment of OSAHS on carotid atherosclerosis.
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