脑卒中患者阻塞性睡眠呼吸暂停低通气综合征与脑梗死复发的相关性研究

Study on the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS)and the recurrence of cerebral infarction

目的探讨脑卒中患者1年内复发与阻塞性睡眠呼吸暂停低通气综合征(OSHAS)的相关性。方法对住院治疗的新发缺血性卒中患者进行前瞻性观察研究,对患者在1周内监测夜间血氧饱和度(SaO 2)和睡眠呼吸暂停次数。依据有无合并OSAHS以及OSAHS程度分组,对照组为单纯脑梗死55例;观察Ⅰ组为脑梗死合并轻度OSAHS 45例,观察Ⅱ组为脑梗死合并中度OSAHS 42例,观察Ⅲ组为脑梗死合并重度OSAHS 38例。收集所有患者一般资料及卒中常见危险因素资料,随访12个月,观察卒中复发情况,用统计学方法处理,复发因子纳入多因素Logistic回归分析。结果脑卒中对照组患者复发率3.60%,观察Ⅰ组为11.11%,观察Ⅱ组为16.67%,观察Ⅲ组为23.68%,观察组与对照组比较差异有统计学意义(P<0.05)。复发因子采用Logistic回归分析显示,呼吸暂停低通气指数、SaO 2能引起脑卒中复发。结论OSAHS是脑卒中的独立危险因素,程度越重脑卒中越容易复发。OSAHS可作为脑卒中复发的预测指标,在缺血性卒中的预防中应将OSAHS列入危险因素进行有效管理。

Objective To investigate the correlation between recurrence of stroke within one year and obstructive sleep apnea hypopnea syndrome(OSAHS).Method The prospective study was carried out on the new ischemic stroke patients.In one week,the night blood oxygen saturation(SaO 2)and the number of sleep apnea were monitored.According to the degree of OSAHS and OSAHS,the patients were divided into four groups,55 patients with simple cerebral infaraction in the control group,45 patients with cerebral infaraction complicated with mild OSAHS in the observation group I,42 patients with cerebral infaraction complicated with OSAHS in the observation group II,38 patients with cerebral infaraction complicated with severity OSAHS in the observation group III.General data and common risk factors of stroke were collected.The patients were followed up for 12 months.The recorded data were treated with statistical method,and the recurrence factors were included in logistic regression analysis.Results The stroke recurrence rate of were 3.60%in the control group,11.11%in the observation group I,16.67%in the observation group II,23.68%in the observation group III,There were significant difference among the three groups(P<0.05).Logistic regression analysis showed that AHI and SaO2 were the risk factors for recurrence of stroke.Conclusion OSAHS is an independent risk factor of stroke.The more serious the degree is,the more likely the stroke will recur.OSAHS can be used as a predictor of stroke recurrence.In the prevention of ischemic stroke,OSAHS should be included in the risk factors for effective management.