中国卒中杂志 ›› 2016, Vol. 11 ›› Issue (11): 912-917.DOI: 10.3969/j.issn.1673-5765.2016.11.003

• 论著 • 上一篇    下一篇

阻塞性睡眠呼吸暂停与觉醒型卒中的关系分析

刘伟,周正宏,史冬梅,刘磊,谢子珍,翟安琪,于逢春,樊东升   

  1. 1100080 北京北京市海淀医院(北京大学第三医院海淀院区)神经内科
    2北京大学第三医院神经科
  • 出版日期:2016-11-20 发布日期:2016-11-20
  • 通讯作者: 于逢春 yufckui@163.com 樊东升 dsfan@sina.com
  • 基金资助:

    北京大学985工程(临床医院合作专项)

    建设项目(题目:缺血性脑卒中现代化预防理论体系及全方位预警机制)

    北京市海淀医院(北京大学第三医院海淀院区)

    重点课题(题目:《高压氧、常规药物治疗对急性失眠障碍患者睡眠量、认知功能、焦虑、抑郁状态的影响》)

Correlation Analysis of Obstructive Sleep Opnea and Wake-up Stroke

  • Online:2016-11-20 Published:2016-11-20

摘要:

目的 讨论阻塞性睡眠呼吸暂停(obstructive s leep a pnea,OSA)与觉醒型卒中(wake-up stroke,WUS) 的关系。 方法 回顾性分析伴阻塞性睡眠呼吸暂停低通气综合征的急性缺血性卒中患者资料,患者均接受夜 间睡眠监测检查,分为WUS组和非WUS组,比较两组间一般临床资料、美国国立卫生研究院卒中量表 (National Institutes of Health Stroke Scale,NIHSS)评分及睡眠呼吸参数等指标的差异。 结果 共入组96例患者,其中WUS组22例,非WUS组74例,WUS组的体质指数(body mass index,BMI) (P =0.030)、呼吸暂停低通气指数(apne a-hypopnea index,AHI)(P =0.001)、血氧饱和度下降指数 (oxygen desaturation index,ODI)(P =0.001)均显著高于非WUS组,平均血氧饱和度(P =0.002)显著 低于非WUS组;Logistic回归分析显示,AHI增高[比值比(odds ratio,OR)1.162,95%可信区间(confidence interval,CI)1.007~1.341]是WUS的独立危险因素。 结论 BMI、AHI、ODI和平均血氧饱和度与阻塞性睡眠呼吸暂停低通气综合征患者发生WUS有关,其中 AHI是WUS的独立危险因素。

文章导读: 通过多因素分析显示在阻塞性睡眠呼吸暂停低通气综合征患者中,呼吸暂停低通气指数是觉醒卒中的独立危险因素。

关键词: 阻塞性睡眠呼吸暂停; 觉醒型卒中; 呼吸暂停低通气指数

Abstract:

Objective To explore the relationship between obstructive sleep apnea (OSA) and wake-up stroke (WUS). Methods The clinical data of patients with ischemic stroke accompanied with OSA were analyzed retrospectively. The patients received sleep monitoring examination at night and were divided into WUS group and non wake-up stroke (non-WUS) group. The differences of the clinical data, National Institutes of Health Stroke Scale (NIHSS) score, etiology and the slee respiratory parameters were compared between the two groups. Results A total of 96 patients were included, among whom, there was 74 cases in non-WUS group and 22 cases in WUS group. The body mass index (BMI) (P =0.030), apnea-hypopnea index (AHI) (P =0.001), and oxygen desaturation index (ODI) (P =0.001) in WUS group were higher than those in non-WUS group. The mean blood pulse oxyhemoglobin saturation (P =0.002) in WUS group was lower than which in non-WUS group. Binary logistic regression analysis indicated that the independent risk factor for WUS was AHI (odds ratio [OR ] 1.162, 95% confidence interval [CI ] 1.007~1.341). Conclusion BMI, AHI, ODI and mean blood pulse oxyhemoglobin saturation are associated with WUS. AHI is an independent risk factor for WUS.

Key words: Obstructive sleep apnea; Wake-up stroke; Apnea-hypopnea index