急性脑梗死合并睡眠呼吸暂停低通气综合征的初步筛查

目的初步探讨急性脑梗死患者睡眠呼吸暂停低通气综合征（SAHS）的患病情况。方法对2008年1月至2008年12月我科收治的急性脑梗死患者200例进行初步筛查,对配合的40例经知情同意后进行多导睡眠呼吸监测（PSG）检查,并随机抽取40例同期收治的EWW嗜睡自评不符合SAHS的急性脑梗死患者做对照,比较患者年龄、体重指数（BMI）、睡眠打鼾史、高血压史、糖尿病史、吸烟史、AHI、最低动脉血氧饱和度（SaO2）及梗死部位与症状。结果急性脑梗死合并SAHS者占急性脑梗死患者的20%,其中以阻塞型及混合型睡眠呼吸暂停居多;45～60岁组患病率最高,占60%;AHI〉20者占70%,病变累及脑干或出现吞咽困难、饮水呛咳等球麻痹症状者SASH较严重。结论急性脑梗死出现球麻痹者常合并较严重的阻塞型睡眠呼吸暂停,睡眠呼吸暂停是脑梗死的独立危险因素,BMI及上气道周围组织功能异常是引起阻塞型睡眠呼吸暂停的重要因素。

Initial screening of acute cerebrovascular infarction patients complicated sleep apnea hypopnea syndrome (SAHS)

Objective To research the condition that acute cerebrovascular infarction patients suffered from sleep apnea hypopnea syndrome（SAHS）.Methods 200 patients with acute cerebrovascular infarction from January 2008 to December 2008 hospitalize in our department were primarily screened,of them 40 patients who could admire and cooperate were undergoing polysomnography（PSG）;patients with acute cerebrovascular infarction at the same time and not suffered from SAHS according to EWW lethargy self-scale were randomly selected.Patients＇age,body weight index（BMI）,history of sleep snore,hypertension,diabetes,smoking,apnea hypopnea index（AHI）,lowest artery blood oxygen solution（SaO2）and the location,symptom of infarction were compared.Results It was 20% that acute cerebrovascular infarction patients with SAHS,of them,obstructive and mixed pattern were majority in sleep apnea syndrome;The group age from 45 to 60 years old suffered the most,the proportion was 60%;the patients whose AHI20 were 70%;the patients with SAHS whose disease located in brain stem and with swallow difficulty,drink cough symptoms were more severe.Conclusion The patients with balloon paralysis accompany with SAHS are more severe conditions.Sleep apnea hypopnea syndrome is an indispensable risk factor of cerebrovascular infarction.BMI and abnormal function of surrounding tissues of upper airway is an important factor to cause obstructive sleep apnea hypopnea syndrome.