打鼾与缺血性脑卒中及预后关系的研究

Association of Snoring with the Risk of Ischemic Stroke and Prognosis

目的探讨打鼾与缺血性脑卒中发生及其预后的关系。方法比较993例脑缺血患者与1432例对照自述打鼾发生的差异,利用logistic回归模型分析打鼾对缺血性脑卒中发病风险的影响;通过对缺血性脑卒中患者的长期随访,利用Kaplan-Meier分析和Cox回归模型分析患者打鼾与否、打鼾程度与缺血性脑卒中复发的关系。结果脑缺血组的打鼾发生率为75.0%,高于对照组64.2%的打鼾发生率,差异具有显著性。校正年龄、性别和传统心脑血管危险因素后,发现打鼾增加了脑缺血发生的风险(OR=1.33,95%CI:1.09-1.62)。平均随访4.6年(0.1~6.0年),结果显示打鼾与缺血性脑卒中的预后无明显关系。进一步分析发现,严重打鼾与缺血性脑卒中的复发相关,累积生存趋势显示严重打鼾增加了脑卒中的复发(P=0.034)。校正年龄、性别和传统心脑血管危险因素后,严重打鼾显著增加了脑缺血患者脑卒中复发的风险(HR=1.93,95%CI:1.19-3.15,P=0.008)。结论打鼾是缺血性脑卒中发生的危险因素,严重打鼾增加了脑缺血患者卒中复发的风险。

Objective To explore the relationship between snoring and the occurrence and prognosis of ischemic stroke.Methods 993 cases of cerebral ischemia and 1432 cases of control group were compared with self-reported snoring.Logistic regression model was used to analyze the impact of snoring on the risk of stroke.Through long-term follow-up of ischemic stroke patients,Kaplan-Meier analysis and Cox regression model were used to analyze the relationship between snoring,snoring degree and stroke prognosis.Results The incidence of snoring was 75.0%in cerebral ischemia group,which was significantly higher than that of 64.2%in control group.After adjusting for age,gender and conventional vascular risk factors,snoring increased the risk of cerebral ischemia(OR=1.33,95%CI:1.09-1.62).After an average follow-up of 4.6 years(0.1-6.0 years),there was no significant relationship between snoring and the prognosis of stroke.Further analysis showed that the snoring degree was related to the prognosis risk of stroke.Kaplan-Meier analysis showed that severe snoring increased the risk of stroke recurrence in patients with cerebral ischemia(P=0.034).After adjusting for age,gender,and conventional vascular risk factors,severe snoring significantly increased the risk of stroke recurrence in patients with cerebral ischemia(HR=1.93,95%CI:1.19-3.15,P=0.008).Conclusion Snoring is a risk factor of ischemic stroke occurrence.Severe snoring increases the risk of stroke recurrence in patients after cerebral ischemia.