关键词: 脑梗死; 睡眠呼吸暂停; 阻塞性; 血压

Abstract: Objective To assess the blood pressure variability(BPV) in acute infarction with obstructive sleep apnea syndrome(OSAS), and to explore the relationship between BPV and stroke.Methods We studied patients with acute cerebral infarction. All of the patients were admitted to the department of neurology, Beijing Haidian Hospital, from Jan. 2009 to Jun. 2010. Overnight polysomnography(PSG) and 24-hour ambulatory blood pressure monitoring recordings were performed on all patients within the first week from the onset of the ischemic stroke. According to the PSG, patients were divided into OSAS group(n=126) and non-OSAS group(n=51) except the patients with central and mixed sleep apnea syndrome and taking anti-hypertension drugs. BPV was expressed as the standard deviation of blood pressure(BP) during a 24 period. The aim of study is to determine the relationships in BP, BPV, the National Institutes of Health Stroke Scale(NIHSS), and so on between groups. Data was analyzed by spss11.5. We used for nominal variables the χ2 test or t test. Singnificance was set at P<0.05. The correlations between the baseline data, clinical complications and recurrent stroke were studied.Results There were significantly higher daytime systolic(138.9±17.8 mmHg vs 131.4±15.8 mmHg, and P-value is less than 0.01), nighttime BPV(12.1±4.7 mmHg vs 8.8±3.7 mmHg, and P-value is less than 0.01) in the OSAS group as compared to the non-OSAS group. There were significantly differences in NIHSS and the number of recurrence stroke between two groups. Hypertention, diabetes mellitus, OSAS, apnea hypopnea index(AHI) and nighttime BPV were related to recurrent stroke(P<0.05). After adjustment for the other factors, nighttime BPV(OR 0.910, 95%CI 0.855-0.969, P=0.003) was a independent risk factor of recurrent stroke.Conclusion The nighttime-BPV was higher in the OSAS group as compared to the non-OSAS group. The BPV was one of the reasons of recurrence of stroke in patients with OSAS.

Key words: Brain infarction; Sleep apnea; obstructive; Blood pressure