睡眠呼吸暂停综合征合并脑卒中的危险因素分析

Risk factor analysis of sleep apnea syndrome combined with cerebral apoplexy

目的探讨睡眠呼吸暂停综合征合并脑卒中的危险因素。方法选取山东大学附属省立医院睡眠中心自2014年6月至2015年6月收治的阻塞性睡眠呼吸暂停综合征合并脑卒中患者39例和同期就诊的单纯阻塞性睡眠呼吸暂停综合征患者45例为研究对象．对所有患者行多导睡眠呼吸监测（PSG）并测定指端最低血氧饱和度（SpO2）、最长呼吸暂停时间（SAmax）、睡眠呼吸暂停低通气指数（AHI）等指标，采用多因素Logistic回归分析方法对睡眠呼吸暂停综合征合并脑卒中的危险因素进行分析。结果2组患者的吸烟率、体重指数（BMI）及纤维蛋白原（Fib）、低密度脂蛋白胆固醇（LDL-C）、超氧化物歧化酶（SOD）水平等指标比较差异均有统计学意义（P〈0．05）。PSG结果显示2组患者的SpO2、SAmax和AHI等指标比较差异均有统计学意义（P〈0．05）。多因素Logistic回归分析显示BMI、SAmax、SpO2和AHI是睡眠呼吸暂停综合征合并脑卒中的危险因素（OR=4．685，95％CI：3．658-6．325，P=0．017；OR=3．569，95％CI：2．875-3．968，P=0．024；OR=4．125，95％CI：4．025-4．569，P=0．034：OR=4．253，95％CI：4．135～5．032，P=0．036）。结论肥胖及体内缺氧程度严重的睡眠呼吸暂停综合征患者合并脑卒中的风险更大。

Objective To investigate the risk factors of sleep apnea syndrome combined with cerebral apoplexy. Methods Thirty-nine patients with obstructive sleep apnea syndrome combined with cerebral apoplexy, admitted to our hospital from June 2014 to June 2015, and 45 patients with obstructive sleep apnea syndrome were selected in our study. Polysomnography （PSG） was performed, and lowest blood oxygen saturation （SpO2）, max apnea time （SAmax） and sleep apnea hypoventilation index （AHI） were recorded in all patients; multivariable Logistic regression analysis was used to analyze the risk factors of sleep apnea syndrome combined with cerebral apoplexy. Results There were significant differences in smoking rate, body mass index （BMI） and fibrinogen （Fib）, low density lipoprotein cholesterol （LDL-C） and superoxide dismutase （SOD） levels between the two groups （P〈 0.05）. PSG results showed that the SpO2, SAmax and AHI indicators were statistically different between the two groups （P〈0.05）. Multivariate Logistic regression analysis showed that BMI, SAra, SpO2 and AHI were the risk factors of sleep apnea syndrome combined with cerebral apoplexy （OR=4.685, 95%CI： 3.658-6.325, P=0.017; OR=3.569, 95%CI： 2.875-3.968, P=0.024; OR=4.125, 95%CI： 4.025-4.569, P= 0.034; OR=4.253, 95%CI： 4.135-5.032, P=0.036）. Conclusion Patients with obesity or severe anoxia have high risk of sleep apnea syndrome combined with cerebral apoplexy.