- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT03665818
The Influence of Mandibular Advancement Device Treating OSAHS on Primary Prevention of Ischemic Stroke
- 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.
- 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.
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
- 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.
- 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.
Tipo de estudo
Inscrição (Antecipado)
Estágio
- Não aplicável
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Experimental: Oral appliance intervention
|
mandibular advancement device to enlarge pharyngeal airway space to get rid of apnea and hypopnea events
|
Sem intervenção: Without oral appliance intervention
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
apnea hypopnea events 0 in Times
Prazo: initial time when patients are recruited
|
apnea and hypopnea times per hour
|
initial time when patients are recruited
|
apnea hypopnea events 1 in Times
Prazo: one month after oral appliance treatment
|
apnea and hypopnea times per hour
|
one month after oral appliance treatment
|
apnea hypopnea events 2 in Times
Prazo: 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
Prazo: initial time when patients are recruited
|
longest apnea or hypopnea time
|
initial time when patients are recruited
|
longest apnea time 1 in Seconds
Prazo: one month after oral appliance treatment
|
longest apnea or hypopnea time
|
one month after oral appliance treatment
|
longest apnea time 2 in Seconds
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
|
Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Publicações Gerais
- Qin L, Li N, Tong J, Hao Z, Wang L, Zhao Y. Impact of mandibular advancement device therapy on cerebrovascular reactivity in patients with carotid atherosclerosis combined with OSAHS. Sleep Breath. 2021 Sep;25(3):1543-1552. doi: 10.1007/s11325-020-02230-x. Epub 2021 Jan 7.
- Hao Z, Qin L, Tong J, Li N, Zhai Y, Zhao Y. The differences of carotid atherosclerosis among non-OSAHS and OSAHS patients of different severities: a cross-sectional study. Sleep Breath. 2021 Jun;25(2):639-648. doi: 10.1007/s11325-020-02145-7. Epub 2020 Jul 27.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Doenças cardiovasculares
- Doenças Vasculares
- Distúrbios Cerebrovasculares
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Doenças Respiratórias
- Arteriosclerose
- Doenças Arteriais Oclusivas
- Apnéia
- Distúrbios Respiratórios
- Distúrbios do Sono Intrínsecos
- Dissônias
- Distúrbios do Sono Vigília
- Derrame
- Síndromes da Apneia do Sono
- AVC Isquêmico
- Aterosclerose
Outros números de identificação do estudo
- CSA-Z2015-06
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