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The Influence of Mandibular Advancement Device Treating OSAHS on Primary Prevention of Ischemic Stroke

21 juillet 2020 mis à jour par: Ying Zhao, Xuanwu Hospital, Beijing
  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.

Aperçu de l'étude

Description détaillée

  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.

Type d'étude

Interventionnel

Inscription (Anticipé)

100

Phase

  • N'est pas applicable

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • diagnosed with atherosclerosis by vascular ultrasonography
  • diagnosed with OSAHS by polysomnography

Exclusion Criteria:

  • patients who have stroke already
  • patients who can not wear oral appliances according to experiment requirements
  • patients who have bad periodontal condition or teeth number less than 20

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Oral appliance intervention
mandibular advancement device to enlarge pharyngeal airway space to get rid of apnea and hypopnea events
Aucune intervention: Without oral appliance intervention

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
apnea hypopnea events 0 in Times
Délai: initial time when patients are recruited
apnea and hypopnea times per hour
initial time when patients are recruited
apnea hypopnea events 1 in Times
Délai: one month after oral appliance treatment
apnea and hypopnea times per hour
one month after oral appliance treatment
apnea hypopnea events 2 in Times
Délai: one and a half years after oral appliance treatment
apnea and hypopnea times per hour
one and a half years after oral appliance treatment
longest apnea time 0 in Seconds
Délai: initial time when patients are recruited
longest apnea or hypopnea time
initial time when patients are recruited
longest apnea time 1 in Seconds
Délai: one month after oral appliance treatment
longest apnea or hypopnea time
one month after oral appliance treatment
longest apnea time 2 in Seconds
Délai: one and a half years after oral appliance treatment
longest apnea or hypopnea time
one and a half years after oral appliance treatment
Blood oxygen saturation less than 90% of the total monitoring time percentage 0 in percentage
Délai: initial time when patients are recruited
Blood oxygen saturation less than 90% of the total monitoring time percentage
initial time when patients are recruited
Blood oxygen saturation less than 90% of the total monitoring time percentage 1 in percentage
Délai: one month after oral appliance treatment
Blood oxygen saturation less than 90% of the total monitoring time percentage
one month after oral appliance treatment
Blood oxygen saturation less than 90% of the total monitoring time percentage 2 in percentage
Délai: one and a half years after oral appliance treatment
Blood oxygen saturation less than 90% of the total monitoring time percentage
one and a half years after oral appliance treatment
lowest Oxygen Saturation 0 in percentage
Délai: initial time when patients are recruited
blood lowest oxygen saturation during the whole night
initial time when patients are recruited
lowest Oxygen Saturation 1 in percentage
Délai: one month after oral appliance treatment
blood lowest oxygen saturation during the whole night
one month after oral appliance treatment
lowest Oxygen Saturation 2 in percentage
Délai: one and a half years after oral appliance treatment
blood lowest oxygen saturation during the whole night
one and a half years after oral appliance treatment
atherosclerosis plaque thickness 0 in common carotid artery in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
initial time when patients are recruited
atherosclerosis plaque thickness 1 in common carotid artery in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
one and a half years after oral appliance treatment
atherosclerosis plaque length 0 in common carotid artery in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
initial time when patients are recruited
atherosclerosis plaque length 1 in common carotid artery in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque length is distance from the beginning to the end of a separate plaqu
one and a half years after oral appliance treatment
atherosclerosis plaque thickness 0 in internal carotid artery in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
initial time when patients are recruited
atherosclerosis plaque thickness 1 in internal carotid artery in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
one and a half years after oral appliance treatment
atherosclerosis plaque thickness 0 in carotid bulb in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
initial time when patients are recruited
atherosclerosis plaque thickness 1 in carotid bulb in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
one and a half years after oral appliance treatment
atherosclerosis plaque length 0 in internal carotid artery in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
initial time when patients are recruited
atherosclerosis plaque length 1 in internal carotid artery in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
one and a half years after oral appliance treatment
atherosclerosis plaque length 0 in carotid bolb in milimetre
Délai: initial time when patients are recruited
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
initial time when patients are recruited
atherosclerosis plaque length 1 in carotid bolb in milimetre
Délai: one and a half years after oral appliance treatment
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
one and a half years after oral appliance treatment
breath holding index 0 in percentage/seconds
Délai: initial time when patients are recruited
breath holding index = (v2-v1)/v2*100/t. v2 is average velocity of middle cerebral artery after breath holding, v1 is average velocity of middle cerebral artery before breath holding, t is time for breath holding.
initial time when patients are recruited
breath holding index 0 in percentage/seconds
Délai: one and a half years after oral appliance treatment
breath holding index = (v2-v1)/v2*100/t. v2 is average velocity of middle cerebral artery after breath holding, v1 is average velocity of middle cerebral artery before breath holding, t is time for breath holding.
one and a half years after oral appliance treatment
End systolic velocity of common carotid artery 0 in cm/s
Délai: initial time when patients are recruited
the velocity of common carotid artery at the end of systolic period
initial time when patients are recruited
End systolic velocity of common carotid artery 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of common carotid artery at the end of systolic period
one and a half years after oral appliance treatment
End systolic velocity of internal carotid artery 0 in cm/s
Délai: initial time when patients are recruited
the velocity of internal carotid artery at the end of systolic period
initial time when patients are recruited
End systolic velocity of internal carotid artery 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of internal carotid artery at the end of systolic period
one and a half years after oral appliance treatment
End systolic velocity of carotid bulb 0 in cm/s
Délai: initial time when patients are recruited
the velocity of carotid bulb at the end of systolic period
initial time when patients are recruited
End systolic velocity of carotid bulb 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of carotid bulb at the end of systolic period
one and a half years after oral appliance treatment
end diastolic velocity of common carotid artery 0 in cm/s
Délai: initial time when patients are recruited
the velocity of common carotid artery at the end of diastolic period
initial time when patients are recruited
end diastolic velocity of common carotid artery 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of common carotid artery at the end of diastolic period
one and a half years after oral appliance treatment
end diastolic velocity of internal carotid artery 0 in cm/s
Délai: initial time when patients are recruited
the velocity of internal carotid artery at the end of diastolic period
initial time when patients are recruited
end diastolic velocity of internal carotid artery 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of internal carotid artery at the end of diastolic period
one and a half years after oral appliance treatment
end diastolic velocity of carotid bulb 0 in cm/s
Délai: initial time when patients are recruited
the velocity of carotid bulb at the end of diastolic period
initial time when patients are recruited
end diastolic velocity of carotid bulb 1 in cm/s
Délai: one and a half years after oral appliance treatment
the velocity of carotid bulb at the end of diastolic period
one and a half years after oral appliance treatment

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

9 juillet 2016

Achèvement primaire (Réel)

1 septembre 2018

Achèvement de l'étude (Réel)

31 décembre 2019

Dates d'inscription aux études

Première soumission

18 juillet 2018

Première soumission répondant aux critères de contrôle qualité

7 septembre 2018

Première publication (Réel)

11 septembre 2018

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

22 juillet 2020

Dernière mise à jour soumise répondant aux critères de contrôle qualité

21 juillet 2020

Dernière vérification

1 juillet 2020

Plus d'information

Termes liés à cette étude

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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