阻塞性睡眠呼吸暂停综合征共患卒中

摘要/Abstract

摘要：

阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）是一个常见病，近期的研究显示其是导致卒中和死亡的危险因素。OSAS在卒中患者中高发，OSAS共患卒中的危险因素与传统的OSAS的危险因素类似。OSAS共患卒中的患者中，持续正压通气治疗可以防止继发性心血管事件，改善神经结局。本综述旨在探讨OSAS和卒中的关系以及OSAS共患卒中患者中的特征及治疗。

文章导读： 本文对阻塞性睡眠呼吸暂停综合征共患卒中的特点、危险因素、治疗等方面进行介绍。

关键词: 阻塞性睡眠呼吸暂停综合征; 卒中; 低通气指数; 持续气道正压

Abstract:

Obstructive sleep apnea syndrome (OSAS) is a prevalent disease and has been increasingly recognized as an factor for stroke and all-cause mortality. OSAS is highly prevalent in patients with stroke. In stroke patients with OSAS, treatment with continous positive airway pressure may prevent subsequent cardiovascular events and improve neurologic outcomes. This review explores the association between OSAS and stroke, and the characterization and treatment of OSAS in patients with stroke.

Key words: Obstructive sleep apnea syndrome; Stroke; Apnea-hypopnea index; Continuous positive airway pressure

冯晶，吴惠涓，赵忠新. 阻塞性睡眠呼吸暂停综合征共患卒中[J]. 中国卒中杂志, 2015, 10(01): 62-65.

FENG Jing, WU Hui-Juan, ZHAO Zhong-Xin. Obstructive Sleep Apnea Syndrome in Patients with Stroke [J]. Chinese Journal of Stroke, 2015, 10(01): 62-65.

参考文献

参考文献

1 Darakul P. Sleep apnea:a novel risk factor in acute stroke and transient ischemic attack[J]. The Bangkok Medical Journal, 2014, 7:32-38.

2 Jie L, Li MX, Liu SN, et al. Is brain damage really involved in the pathogenesis of obstructive sleep apnea[J]. Neuroreport, 2014, 25:593-595.

3 Tsivgoulis G, Alexandrov AV. Cerebral autoregulation impairment during wakefulness in obstructive sleep apnea syndrome is a potential mechanism increasing stroke risk[J]. Eur J Neurol, 2009, 16:283-284.

4 Dumitrascu R, Tiede H, Rosengarten B, et al. Obstructive sleep apnea and stroke[J]. Pneumologie, 2012, 66:476-479.

5 吴江. 神经病学[M]. 北京:人民卫生出版社, 2012:436.

6 Calvin AD, Somers VK. Obstructive sleep apnea and risk of stroke:time for a trial[J]. Nat Clin Pract Cardiovasc Med, 2009, 6:90-91.

7 Redline S, Yenokyan G, Daniel J, et al. Obstructive sleep apnea-hypopnea and incident stroke[J]. Am J Respir Crit Care Med, 2010, 182:269-277.

8 Hamilton GS, Naughton MT. Impact of obstructive sleep apnoea on diabetes and cardiovascular disease[J]. Med J Aust, 2013, 199:S27-30.

9 周正宏, 于逢春, 孟晓梅, 等. 阻塞性睡眠呼吸暂停低通气综合征与非心源性缺血性卒中复发关系探讨[J]. 中国卒中杂志, 2013, 8:697-702.

10 Arter JL, Chi DS, M G, et al. Obstructive sleep apnea, inflammation, and cardiopulmonary disease[J]. Front Biosci, 2004, 1:2892-2900.

11 Jacqueline ML, Mark NA, Ann CG. The relationship between obstructive sleep apnea and atrial fibrillation:A complex interplay[J]. Pulm Med, 2013, 1:1-11.

12 Arzt M, Young T, Peppard PE, et al. Dissociation of obstructive sleep apnea from hypersomnolence and obesity in patients with stroke[J]. Stroke, 2010, 3:129-134.

13 Bassetti CL, Milanova M, Gugger M. Sleep-disordered breathing and acute ischemic stroke:diagnosis, risk factors, treatment, evolution, and long-term clinical outcome[J]. Stroke, 2006:37:967-972.

14 Wessendorf TE, Wang YM, Thilmann AF, et al. Treatment of obstructive sleep apnea with nasal continous positive airway pressure in stroke[J]. Eur Respir J, 2001:18:623-629.

15 Chen CY, Hsu CC, Pei YC, et al. Nocturia is an independent predictor of severe obstructive sleep apnea in patients with ischemic stroke[J]. Neurology, 2011, 258:189-194.

16 Medeiros CA, Bruin VM, Castro-Silva CD, et al. Neck circumference, a bedside clinical feature related to mortality of acute ischemic stroke[J]. Rev Assoc Med Bras, 2011, 57:559-564.

17 Turkington PM, Bamford J, Wanklyn P, et al. Prevalence and predictors of upper airway obstruction in the first 24 hours after acute stroke[J]. Stroke, 2002, 33:2037-2042.

18 Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients:A meta-analysis[J]. J Clin Sleep Med, 2010, 6:131-137.

19 Durgan DJ, Bryan RM. Cerebrovascular consequences of obstructive sleep apnea[J]. J Am Heart Assoc, , 2012, 1(4):e000091. doi:10.1161.

20 Ryan M, Bayley M, Robin R, et al. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea[J]. Stroke, 2011, 42:1062-1067.

21 Justine AA, Coen AB, Winni FH, et al. The effect of obstructive sleep apnea and treatment with continuous positive airway pressure on stroke rehabilitation:rationale, design and methods of the TOROS study[J]. BMC Neurol, 2014, 14:36-42.

22 Camilo MR, Sander HH, Eckeli A, et al. SOS score:an optimized score to screen acute stroke patients for obstructive sleep apnea[J]. Sleep Med, 2014, 15:1021-1024.

23 阻塞性睡眠呼吸暂停与卒中诊治专家共识组. 阻塞性睡眠呼吸暂停与卒中诊治专家共识[J]. 中华内科杂志, 2014, 8:657-664.

24 Bazzano LA, Gu D, Whelton MR, et al. Body mass index and risk of stroke among Chinese men and women[J]. Ann Neurol, 2010, 67:11-20.

25 Bravata DM, Concato J, Fried T, et al. Continuous positive airway pressure:evaluation of a novel therapy for patients with acute ischemic stroke[J]. Sleep, 2011, 34:1271-1277.

26 Ryan CM, Bayley M, Green R, et al. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea[J]. Stroke, 2010, 42:1062-1067.

27 Parra O, Sanchez-Armengol A, Bonnin M, et al. Early treatment of obstructive apnoea and stroke outcom:a randomised controlled trial[J]. Eur Respir, 2011, 37:1128-1136.

28 Martinez-Garcia MA, Campos-Rodriguez F, Soler-Cataluna JJ, et al. Increased incidence of nonfatal cardiovascular events in stroke patients with sleep apnoea:effect of CPAP treatment[J]. Eur Respir, 2012, 39:906-912.

29 Savransky V, Nanayakkra A, Li J, et al. Chronic intermittent hypoxia induces atherosclerosis[J]. Am J Respir Crit Care Med, 2007, 175:1290-1297.

30 Ravesloot MJ, Maanen JP, Dun N, et al. The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature[J]. Sleep Breath, 2013, 17:39-49.

31 Maanen JP, Kristel AW, Dun LN, et al. The sleep position trainer:a new treatment for positional obstructive sleep apnoea[J]. Sleep Breath, 2013, 17:771-779.

32 Camilo MR, Fernandes RMF, Sander HH, et al. Suppine sleep and positional sleep apnea after acute ischemic stroke and intracerebral hemorrhage[J]. Clinics, 2012, 67:1357-1360.

33 Oksenberg A, Gadoth N. Are we missing a simple treatment for most adult sleep apnea patient? The avoidance of the supine sleep position[J]. J Sleep Res, 2014, 23:204-210.

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