老年睡眠呼吸暂停低通气综合征患者的脑血管造影结果分析

Clinical analysis for the cerebral angiography results in elderly patients with sleep apnea hypopnea syndrome

目的探讨老年睡眠呼吸暂停低通气综合征(SAHS)患者出现脑血管狭窄或闭塞的发病率、血管病变的部位以及SAHS严重程度与血管病变部位的关系。方法选取36例经多导睡眠图(PSG)监测证实的老年SAHS症状性脑血管病(CVD)患者,60~92岁,轻度8例,中度18例,重度10例,通过全脑数字减影血管造影(DSA)检查分析老年SAHS患者血管狭窄的部位、狭窄程度及狭窄血管支数。结果DSA诊断脑供血动脉狭窄或闭塞33例(91.7%),其中颅内动脉占12例(33.3%),颅外动脉占9例(25.0%),颅内外混合12例(33.3%)。8例轻度老年SAHS患者中除2例未见动脉狭窄外,单纯颅外动脉狭窄或闭塞2例,单纯颅内动脉狭窄或闭塞2例,颅内外动脉多发性狭窄或闭塞2例;18例中度老年SAHS患者中除1例未见动脉狭窄外,单纯颅外动脉狭窄或闭塞5例,单纯颅内动脉狭窄或闭塞6例,颅内外动脉多发性狭窄或闭塞6例;10例重度老年SAHS患者中单纯颅外动脉狭窄或闭塞2例,单纯颅内动脉狭窄或闭塞3例,颅内外动脉多发性狭窄或闭塞5例。结论 老年SAHS患者易合并中、重度脑血管狭窄或闭塞,累及颅内动脉及颅内外动脉较多见,其中以大脑中动脉和颈内动脉颅内段及二者混合受累较多见。

Objective To investigate the incidence rate of cerebral vascular stenosis or occlusion,the location of vascular lesions,and the relationship between the severity of SAHS and vascular lesions in elderly patients with sleep apnea hypopnea syndrome(SAHS).Methods Thirty-six elderly patients with symptomatic cerebral vascular disease(CVD) who were diagnosed by polysomnography(PSG) were enrolled in this study,whose age range was 60~92 years,including 8 mild cases,18 moderate cases and 10 severe cases.The whole-brain digital subtraction angiography(DSA) was used to detect the location of vascular stenosis,the degree of stenosis,and the number of stenotic vessels in elderly patients with SAHS.Results DSA examination results showed that there were 33 cases(91.7%) of cerebral blood supply artery stenosis or occlusion,including 12 cases(33.3%) of intracranial arteries,9 cases(25.0%) of extracranial arteries and 12 cases(33.3%) of intracranial with extracranial.Among the 8 patients with mild SAHS,except for 2 patients without arterial stenosis,there were 2 cases of simple extracranial stenosis or occlusion,2 cases of simple intracranial artery stenosis or occlusion,and 2 cases of multiple stenosis of the intracranial or extracranial artery. Among the 18 patients with moderate elderly SAHS,except for 1 patient without arterial stenosis,there were 5 cases of simple extracranial stenosis or occlusion,6 cases of simple intracranial stenosis or occlusion,and 6 cases of multiple intracranial or extracranial stenosis.Among the 18 patients with severe elderly SAHS,there were 2 cases of simple extracranial stenosis or occlusion,3 cases of simple intracranial stenosis or occlusion,and 5 cases of multiple stenosis or occlusion of the intracranial and extracranial arteries.Conclusion The elderly patients with SAHS are more likely to be complicated by moderate and severe cerebrovascular stenosis or occlusion,which are commonly involved in the intracranial arteries and extracranial arteries,in which, there are more lesions of mixed involvement.