急性脑血管病与睡眠呼吸障碍的关系研究

Study on the relationship between the acute cerebrovascular disease and sleep-disordered breathing

目的 探讨急性脑血管病与睡眠呼吸障碍(SDB)的关系。方法 利用多导睡眠图(PSG)对86例急性脑血管病患者进行睡眠全程监测,并选择年龄、性别和体重指数(BMI)相当的健康体检者50例作为正常对照组。结果 研究组睡眠结构紊乱,表现为睡眠效率降低、深睡期和快速眼动(REM)睡眠时间减少、浅睡时间延长,与正常对照组比较,均有显著性差异(均为P<0. 01);同时与正常对照组比较,研究组夜间鼾声指数和呼吸紊乱指数(RDI)明显增高(均为P<0. 01),氧减指数(ODI)和动脉血氧饱和度(SaO2 )明显降低(均为P<0. 01),其中58例(67. 44% )诊断为阻塞性睡眠呼吸暂停综合征。研究组中睡眠发病率明显高于清晨觉醒后和活动时(均为P<0. 01)。结论 睡眠呼吸障碍,尤其是阻塞性睡眠呼吸暂停(OSA)与急性脑血管病的关系密切,既是其发病的独立危险因素,又是其结果;早期诊治睡眠呼吸障碍对于脑血管病的预防、治疗和康复有重要意义。

Objective To investigate the relationship between acute cerebrovascular disease (CVD) and sleep-disordered breathing(SDB).Methods Polysomnography (PSG) in 86 patients with CVD and 50 age-,sex-and body mass index(BMI) -matched healthy control subjects was monitored.Results In the study group,the patients presented the disturbance of sleep structure,with the mean percentage of sleep efficiency,both deep sleep stage(3 and 4 )and rapid eye movement(REM) sleep were significantly lower in the patients than in healthy control subjects (P<0.01 );the mean sleep stage(1 and 2) was significantly higher in the study group than in healthy control group (P<0.01).Obstructive sleep apnea syndrome (OSAS) was found in 58 of 86 patients(67.44%) with CVD,the mean snoring index and respiratory disturbance index (RDI) were significantly higher in the study group than in healthy control group (P<0.01);the mean oxygen desaturation index (ODI) and SaO 2% were significantly lower in the patients than in healthy control group (P<0.01).The CVD occurrence rate in the study group was increased during sleep (50%) compared to that after morning awake (P<0.01).Conclusion There is a close relationship between SDB,especially OSAS and CVD.SDB is not only the risk of CVD,but also its result.Early diagnosis and treatment of SDB is of great significance to the prevention,management and rehabilitation of CVD.