体位对急性脑梗死患者睡眠呼吸紊乱的影响

Effect of body posture on sleep-related breathing disorders in patients with acute cerebral infarction

目的探讨睡眠体位对脑梗死患者睡眠呼吸紊乱的影响和作用机制。方法选择急性脑梗死患者53例,分为睡眠呼吸暂停综合征(SAHS)组34例,非SAHS组19例。采用视频多导睡眠监测仪,对急性脑梗死患者自然睡眠过程及不同体位睡眠呼吸状况进行全程描记。结果 53例患者中,有34例(64.2%)急性脑梗死患者睡眠呼吸暂停低通气指数(AHI)≥10。与仰卧位比较,SAHS组左、右侧卧位患者的AHI明显降低,平均血氧饱和度明显升高(P<0.05,P<0.01);且睡眠呼吸紊乱事件以阻塞型为主,仰卧位最重(P<0.01);SAHS组患者自然睡眠状态下,AHI与侧卧位/仰卧位睡眠时间比值呈负相关(r=-0.56,P<0.01)。结论脑梗死后睡眠呼吸紊乱发生率高,仰卧位时加重,体位自我调节保护睡眠呼吸的功能减弱。

Objective To study the effect of body posture on sleep-related breathing disorders （SRBD）in patients with acute cerebral infarction（ACI）. Methods Fifty-three ACI patients were divided into sleep apnea hypersomnolence syndrome（SAHS） group（n= 34）and non-SAHS group （n=-19）. Natural sleeping and breathing of the ACI patients at different body postures were recorded with a video-polysomnography system. Results Among the 53 ACI patients,the AHI was 〉10 in 34（64.2%）. The AHI was significantly lower and the average blood oxygen satuation was significantly higher in SAHS patients sleeping at the left and right posture than in those sleeping at the supine posture（P〈0.05 ,P〈0.01）. In addition,the most common type of SRBD was obstructive, which was most severe when the patients slept at the supine posture（P〈0.01）. The AHI in SAHS patients at natural sleeping was negatively related with the sleeping time at lateral posture/supine posture（r=-0.56,P〈0.01）. Conclusion The incidence of SRBD is high in patients with cerebral infarction. SRBD will aggravate when the patients sleep at the supine posture. Self adjustment of body posture can protect the breathing against becoming weaker at sleeping.