TIA和轻型卒中患者合并睡眠呼吸暂停低通气综合征的临床研究

Clinical study of TIA and mild stroke patients with sleep apnea hypopnea syndrome

目的:探究短暂性脑缺血发作(TIA)和轻型卒中患者合并睡眠呼吸暂停低通气综合征(SAHS)的临床关系。方法:选取某院收治的205例TIA合并轻型脑卒中患者为观察对象,回顾性分析患者的临床资料。依据患者是否合并不同程度的SAHS将其分为A组93例(单纯TIA合并轻型脑卒中患者)、B组58例(TIA和轻型脑卒中合并轻度SAHS患者)、C组37例(TIA和轻型脑卒中合并中度SAHS患者)、D组17例(TIA和轻型脑卒中合并重度SAHS患者)。比较4组患者的血气分析情况、缺血性卒中复发情况,并对TIA和轻型卒中患者缺血性卒中复发进行单因素和Logistic多因素分析。结果:氧饱和度(SaO2)水平由高到低依次别为A组、B组、C组和D组,血氧分压(PaO2)和血二氧化碳分压(PaCO2)水平由低到高依次为D组、C组、B组和A组,差异具有统计学意义(P<0.05);A组、B组、C组和D组患者缺血性卒中复发率分别为18.27%、22.41%、29.72%和35.29%,差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,男性、吸烟、酗酒、有脑卒中家族史、颈围大、腰臀比大、SAHA中度以上、肥胖、高龄、高FBG、高TG、低HDL-C为2型糖尿病患者缺血性卒中发病的危险因素(P<0.05)。结论:SAHA中度以上TIA合并轻型脑卒中患者缺血性卒中复发率较高,积极防治危险因素是降低TIA合并轻型脑卒中患者缺血性卒中复发的有效措施。

Objective: To investigate the clinical relation between transient ischemic attack (TIA) and sleep apnea hypopnea syndrome (SAHS) in patients with mild stroke. Methods: 205 TIA patients with mild stroke were included in the study, and the clinical data of the patients were retrospectively analyzed. All the patients were divided into 4 groups: group A (N = 93, simple TIA and mild stroke), group B (N = 58, TIA and mild stroke with mild SAHS), group C (N = 37, TIA and mild stroke with moderate SAHS), and group D (N = 17, TIA and mild stroke with severe SAHS). Blood gas analysis and recurrence of ischemic stroke were compared among the 4 groups of patients, and single factor and logistic multivariate factor analysis of ischemic stroke recurrence in TIA and mild stroke patients was conducted. Results: The oxygen saturation (SaO 2 ) levels ranking in descending order were respectively groups A, B, C, and D ( P <0.05), while the partial pressure of oxygen (PaO 2 ) and blood carbon dioxide pressure (PaCO 2 ) levels ranking in ascending order were respectively groups D, C, B, and A ( P <0.05). The recurrence rates of ischemic stroke in groups A, B, C and D were respectively18.27%, 22.41%, 29.72% and 35.29%. The difference was statistically significant ( P <0.05). Logistic multivariate analysis showed that males, smoking, alcoholism, family history of stroke, neck circumference, waist to hip ratio, SAHA moderate, obesity, high age, high FBG, high TG, and low HDL-C were risk factors for ischemic stroke in type 2 diabetic patients ( P <0.05). Conclusion: The recurrence rate of ischemic stroke is higher in patients with moderate TIA complicated with mild stroke, and active prevention of risk factors is decisive to reduce the recurrence of ischemic stroke in patients with TIA complicated with mild stroke.