关键词: 缺血性卒中; 阻塞性睡眠呼吸暂停低通气综合征; 复发

Abstract:

【Abstract】 Objective To explore the relationship of the recurrence of non-cardiac ischemic stroke with the severity of obstructive sleep apnea-hypopnea syndromes (OSAHS). Methods In our prospective observational study, we enrolled 227 patients hospitalized in the Department of Neurology, Beijing Haidian Hospital from March 2008 to July 2011. According to apnea hypopnea index (AHI), these patients were divided into four groups:pure non-cardiac ischemic stroke group (group Ⅰ, n=52), non-cardiac ischemic stroke combined with mild OSAHS group (group Ⅱ, n=60), non-cardiac ischemic stroke combined with moderate OSAHS group (group Ⅲ, n=59), and non-cardiac ischemic stroke combined with severe OSAHS group (group Ⅳ, n=56). Then we collected the baseline information, recorded other related risk factors (such as hypertension, smoking history), and kept the results of polysomnography. The patients were followed up after 12 months. The amounts of ischemic stroke recurrence events and the influencing factors were compared with the results taken previously among different groups using Logistic regression analysis. Results The recurrence rates of pure non-cardiac ischemic stroke group, non-cardiac ischemic stroke combined with mild OSAHS group, non-cardiac ischemic stroke combined with moderate OSAHS group, non-cardiac ischemic stroke combined with severe OSAHS group after one year were 3.8%, 5.0%, 11.9%, and 16.4%, respectively. The statistics results show that the number of non-cardiac ischemic stroke combined with severe OSAHS group's ischemic stroke recurrence events is with significant difference compared with both pure non-cardiac ischemic stroke group and non-cardiac ischemic stroke combined with mild OSAHS group (P=0.033, 0.046). While there is no significant difference observed among the other groups (P=0.768, 1.177, 0.490, 0.123). According to the Logistic regression analysis, it shows that body mass index (BMI) (odds ratios [OR] 3.126, 95% confidence interval [CI] 2.079~4.700, P<0.001), hypertension (OR 3.258, 95%CI 1.308~8.111, P=0.011), AHI(OR 1.071, 95%CI 1.038~1.105, P<0.001), SaO2 (OR 0.907, 95%CI 0.848~0.969, P=0.004) are related with the recurrence of ischemic stroke, which are also the independent risk factors at the same time. Conclusion OSAHS, obesity and hypertension are the possible independent risk factors led to the recurrence of non-cardiac ischemic stroke.

Key words: Ischemic stroke; Obstructive sleep apnea hypopnea syndromes; Recurrence