皮质醇联合美国国立卫生研究院卒中量表评分及呼吸暂停低通气指数对脑梗死合并阻塞性睡眠呼吸暂停综合征患者的诊断价值

Diagnostic value of cortisol combined with National Institute of Health Stroke Scale score and apnea hypopnea index in patients with cerebral infarction complicated by obstructive sleep spnea syndrome

目的探讨皮质醇(Cor)联合美国国立卫生研究院卒中量表(NIHSS)评分和呼吸暂停低通气指数(AHI)对脑梗死合并阻塞性睡眠呼吸暂停综合征(OSAS)患者的诊断价值。方法选取武汉市江夏区中医医院神经内科2020年3月至2021年9月期间住院并且完成多导睡眠监测(PSG)的脑梗死患者135例。根据患者是否发生OSAS分为脑梗死组(55例)和脑梗死合并OSAS组(80例)。收集患者的基线资料、生化指标、血清Cor水平、睡眠参数、清晨血压及NIHSS评分和AHI等数据。采用Logistic回归分析脑梗死患者合并OSAS的影响因素,采用Pearson分析Cor与NIHSS评分和AHI的相关性,采用ROC曲线分析Cor、NIHSS及AHI对脑梗死患者发生OSAS的诊断效能。结果Logistic回归模型分析结果显示Cor、NIHSS及AHI是脑梗死合并OSAS发生的影响因素(OR=2.305、2.196、2.248,P<0.05)。Cor水平与NIHSS评分和AHI均呈正相关(r=0.915、0.903,均P<0.05)。ROC曲线显示Cor、NIHSS及AHI对脑梗死患者发生OSAS诊断评估中的AUC均在0.75以上;联合检测的AUC为0.957,高于单独检测(Z=2.925、2.644、2.873,P<0.05),有较高的敏感度(92.00%)和特异度(90.00%)。结论脑梗死患者发生OSAS的影响因素包括Cor、NIHSS及AHI,临床上可以联合Cor、NIHSS及AHI对脑梗死合并OSAS患者进行早期诊断。

Objective To investigate the diagnostic value of cortisol(Cor)combined with the National Institute of Health Stroke Scale(NIHSS)score and the apnea hypopnea index(AHI)in patients with cerebral infarction complicated by obstructive sleep apnea syndrome(OSAS).Methods A total of 135 hospitalized patients with cerebral infarction who were admitted to the department of neurology,Hospital of Traditional Chinese Medicine,Jiangxia District,Wuhan City from March 2020 to September 2021 and underwent polysomnography(PSG)were selected.Patients were divided into the cerebral infarction group(55 cases)and the cerebral infarction complicated by OSAS group(80 cases)according to whether OSAS occurred.Baseline data,biochemical indicators,serum Cor levels,sleep parameters,morning blood pressure,NIHSS score,and AHI data were collected.The influencing factors in patients with cerebral infarction complicated by OSAS were analyzed by Logistic reression analysis.Correlations between Cor,NIHSS scores,and AHI were analyzed by Pearson analysis.Furthermore,the diagnostic value of Cor,NIHSS,and AHI for OSAS in patients with cerebral infarction was evaluated by ROC curve.Results Logistic regression analysis revealed that Cor,NIHSS and AHI were influencing factors for the occurrence of cerebral infarction complicated by OSAS(OR=2.305,2.196,2.248;P<0.05).Cor levels showed positive correlations with NIHSS score and AHI(r=0.915,0.903;both P<0.05).The diagnostic evaluation of Cor,NIHSS,and AHI for OSAS in cerebral infarction patients showed AUCs of ROC curve above 0.75.The combined detection had an AUC of 0.957,which was higher than individual detection(Z=2.925,2.644,2.873;P<0.05),and exhibited high sensitivity(92.00%)and specificity(90.00%).Conclusion Factors influencing OSAS in patients with cerebral infarction include Cor,NIHSS,and AHI.Clinically,the combination of Cor,NIHSS,and AHI can aid in the early diagnosis of cerebral infarction complicated by OSAS.