急性缺血性脑卒中患者发生Cheyne-Stokes呼吸相关因素分析

Analysis of related factors of Cheyne-Stokes respiration in patients with acute ischemic stroke

目的分析急性缺血性脑脑卒中患者发生Cheyne-Stokes呼吸(CSR)的相关危险因素。方法将2015年10月至2017年9月在延安大学附属医院因急性缺血性脑卒中住院并接受过睡眠呼吸暂停测试的患者纳入本次研究,按患者是否发生CSR分为两组,CSR组31例和非CSR组128例,对比两组患者间脑卒中的临床进程以及与呼吸事件相关的参数,分析危险因素。结果两组年龄、心房颤动发生率、心力衰竭发生率、mRS评分、心源性脑卒中、其他原因脑卒中、双侧半球受累、左心房容积指数(LAVI)、LAVI>34 mL/m2患者数、左心射血分数(LVEF)<50%的差异具有统计学意义(t/χ2=5.482、10.962、12.631、1.853、4.001、5.802、6.671、2.362、4.102、11.152,P<0.05)。多因素分析显示,mRS评分、双侧半球受累、LAVI>34 mL/m2、LVEF<50%与CSR显著相关(OR=2.322、6.471、1.362、6.222,P<0.05)。结论心源性脑卒中易发生CSR,且神经功能障碍、低LVEF是CSR的相关因素。

Objective To analyze the risk factors of Cheyne-Stokes respiration(CSR)in patients with acute ischemic stroke.Methods Patients who were hospitalized for acute ischemic stroke and received a sleep apnea test at the Yan'an university hospital from October 2015 to September 2017 were included in the study.Patients were divided into two groups according to whether they had CSR.The CSR group(n=31)and the non-CSR group(n=128)were compared for the clinical course of stroke and the parameters related to respiratory events between the two groups,and the risk factors were analyzed.Results Age,incidence of atrial fibrillation,incidence of heart failure,modifiedrankin scale score(mRS),cardioembolic stroke,other causes of stroke,bilateral hemisphere involvement,left atrial volume index(LAVI),rate of LAVI>34 mL/m2 and the left ventricular contraction ejection fraction(LVEF)<50%was statistically significant(t/χ2=5.482,10.962,12.631,1.853,4.001,5.802,6.671,2.362,4.102,11.152,P<0.05)between CSR and non-CSR group.Multivariate analysis showed that MRS score,bilateral hemisphere involvement,LAVI>34 mL/m2,LVEF<50%were significantly associated with CSR(OR=2.322,6.471,1.362,6.222,P<0.05).Conclusion Cardioembolic stroke is prone to CSR,and neurological dysfunction,low LVEF are related factors for CSR.