急性缺血性卒中患者阻塞性睡眠呼吸暂停低通气综合征的严重程度与炎性因子的临床研究

Clinical study on severity of obstructive sleep apnea hypopnea syndrome and inflammatory factors in patients with acute ischemic stroke

目的研究急性缺血性卒中患者阻塞性睡眠呼吸暂停低通气综合征的严重程度与炎性因子的关系。方法收集2018年1月至2020年1月期间郑州市第三人民医院神经内科住院的91例急性缺血性卒中患者的病例资料,所有患者入院2周后完善多导睡眠仪检查,根据呼吸暂停低通气指数(apnea hypopnea index,AHI)将患者分为轻度OSAHS组(AHI为5~15次/h),中重度OSAHS组(AHI≥15次/小时)和非OSAHS组。并比较三组患者之间的IL-6、PAI-1、Lp-PLA2水平的变化。结果共纳入急性缺血性卒中患者91例,其中OSAHS组58例(64%),非OSAHS组33例(36%),两组患者一般资料比较,性别、年龄、BMI、糖尿病患病率、心房纤颤患病率、低密度脂蛋白、血糖差异无统计学意义(P>0.05),两组患者的IL-6、PAI-1、Lp-PLA2比较差异有统计学意义(P<0.05)。其中,轻度OSAHS组18例(19.8%),中重度OSAHS组40例(44.0%),非OSAHS组33例(36.3%),三组患者的IL-6、PAI-1、Lp-PLA2比较差异有统计学意义(P<0.05),中重度OSAHS组患者IL-6、PAI-1、Lp-PLA2水平与轻度OSAHS组差异有统计学意义(P值分别为0.002、0.010、0.001,P<0.05),中重度OSAHS组患者IL-6、PAI-1、Lp-PLA2水平与非OSAHS组差异有统计学意义(P值分别为0.009、0.011、0.004,P<0.05),且中重度OSAHS组IL-6、PAI-1、Lp-PLA2水平高于轻度OSAHS组与非OSAHS组,轻度OSAHS组IL-6、PAI-1、Lp-PLA2水平与非OSAHS组差异无统计学意义(P值分别为0.078、0.061、0.092,P>0.05)。结论伴中重度OSAHS的AIS患者的IL-6、PAI-1、Lp-PLA2水平明显高于伴轻度OSAHS和不伴OSAHS的患者,而伴轻度OSAHS的AIS患者的IL-6、PAI-1、Lp-PLA2水平与不伴OSAHS的患者相比没有差异。

Objective To study the relationship between the severity of acute ischemic stroke with obstructive sleep apnea hypopnea syndrome and inflammatory factors.Methods The clinical data of 91 patients with acute ischemic stroke who were admitted to the Department of Neurology,the Third People's Hospital of Zhengzhou from January 2018 to January 2020 were collected.Improve polysomnography in all patients within 2 weeks of admission.The patients'apnea hypopnea index(AHI)divided patients into mild OSAHS group(AHI 5-15 times/hour),moderate to severe OSAHS group(AHI≥15 times/hour),and non-OSAHS group.The changes of IL-6,PAI-1,Lp-PLA2 levels among the three groups were compared.Results A total of 91 patients with acute ischemic stroke were treated,There were 58 cases(64%)in the OSAHS group and 33 cases(36%)in the non-OSAHS group.There was no significant difference in general information of patients between the two groups,such as gender,age,BMI,diabetes prevalence,atrial fibrillation prevalence,low density lipoprotein(LDL)and blood glucose(P>0.05).The IL-6,PAI-1 and Lp-PLA2 in the two groups were significantly different(P<0.05).There were 18 cases(19.8%)of mild OSAHS,40 cases(44.0%)of moderate and severe OSAHS,and 33 cases(36.3%)of non-OSAHS.The levels of IL-6,PAI-1 and Lp-PLA2 in the patients of moderate to severe OSAHS group are significantly different from those of the patients of mild OSAHS group(P values are 0.002,0.010 and 0.001,respectively,P<0.05).The levels of IL-6,PAI-1,Lp-PLA2 in patients with moderate to severe OSAHS group were significantly different from those in non-OSAHS group(P values were 0.009,0.011,and 0.004,respectively,P<0.05).Moreover,the levels of IL-6,PAI-1,and Lp-PLA2 in patients with moderate to severe OSAHS group were higher than those in patients with mild OSAHS group and non-OSAHS group.The levels of IL-6,PAI-1,Lp-PLA2 in the mild OSAHS group were not significantly different from those in the non-OSAHS group(P values were 0.078,0.061,and 0.092,respectively,P>0.05).Conclusion The levels of IL-6,PAI-1 and Lp-PLA2 in AIS patients with moderate to severe OSAHS are significantly higher than those in patients with mild OSAHS and patients without OSAHS,while the levels of IL-6,PAI-1 and Lp-PLA2 in AIS patients with mild OSAHS are not different from those in patients without OSAHS.