阻塞性睡眠呼吸暂停低通气综合征与后循环短暂性脑缺血发作的相关性临床研究

A clinical study on the association between obstructive sleep apnea-hypopnea syndrome and transient ischemic attack in posterior circulation

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与后循环短暂性脑缺血发作(TIA)的相关性及其发病机制。方法选取我院住院治疗的30例后循环TIA患者作为病例组;34例非后循环TIA患者作为对照组。收集所有研究对象的基本临床资料及多导睡眠检测结果。回顾性分析不同程度OSAHS在两组中的分布特点。采用二元Logistic回归分析法分析后循环TIA与其危险因素及OSAHS之间的相关性;采用Spearman分析法分析OSAHS与后循环TIA危险因素之间的关系。结果病例组OSAHS患者例数为24例,对照组为18例,差异具有统计学意义(P<0.05);病例组重度OSAHS例数11例,对照组2例,差异具有统计学意义(P<0.05);重度OSAHS与后循环TIA之间有相关性。糖尿病、低密度脂蛋白(LDL)、甘油三酯、BMI、同型半胱氨酸(Hcy)和吸烟为后循环TIA的独立危险因素;而OSAHS不是后循环TIA的独立危险因素。OSAHS与吸烟、高血压、BMI和Hcy等危险因素有显著相关性。结论 OSAHS是后循环TIA发病的危险因素之一,但不是独立危险因素。OSAHS通过与吸烟、高血压、BMI和同型半胱氨酸等危险因素相互作用,促进后循环TIA的发病。

Objective To investigate the association between obstructive sleep apnea-hypopnea syndrome （OSAHS） and transient ischemic attack （TIA） in posterior circulation and related pathogenesis.Methods A total of 30 patients with TIA in posterior circulation who were hospitalized and treated in our hospital were enrolled as case group,and 34 patients without TIA in posterior circulation were enrolled as control group.The general clinical data and the results of polysomnography were collected for all patients.The distribution characteristics of varying degrees of OSAHS in two groups were analyzed retrospectively.The binary logistic regression analysis was used analyze risk factors for TIA in posterior circulation and its association with OSAHS,and the Spearman correlation test was used to investigate the association between OSAHS and risk factors for TIA in posterior circulation.Results A total of 24 patients in the case group and 18 in the control group had OSAHS,and there was a significant difference between the two groups （P ＜ 0.05）;11 patients in the case group and 2 in the control group had severe OSAHS,and there was a significant difference between the two groups （P ＜0.05）.Severe OSAHS was associated with TIA in posterior circulation.Diabetes,low-density lipoprotein,triglyceride,body mass index （BMI）,homocysteine （Hcy）,and smoking were independent risk factors for TIA in posterior circulation,while OSAHS was not an independent risk factor for TIA in posterior circulation.OSAHS was significantly associated with smoking,hypertension,BMI,and Hcy.Conclusions OSAHS is a risk factor for TIA in posterior circulation,but it is not an independent risk factor.OSAHS promotes the development of TIA in posterior circulation by interacting with other risk factors such as smoking,hypertension,BMI,and Hcy.