阻塞性睡眠呼吸暂停综合征患者脑血流动力学研究

目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者的脑血流动力学变化。方法40例符合OSAS诊断标准的患者入选试验组，40例健康人作对照组。对上述受检者进行经颅多普勒超声（TCD）检查：观察颅内动脉血流速度，有无狭窄、闭塞、血流频谱改变。结果40例OSAS患者中，TCD检查异常33例（33／40，82．5％），其中血流速度减慢27例（67．5％），血管狭窄（17．5％）6例；40例对照组中，TCD检查发现异常7例（17．5％），OSAS患者TCD异常检出率显著高于对照组（Х^2=48．5，P〈0．01）。随访1年，OSAS患者6例有脑血管事件发生（15．0％），对照组中仅1例脑血管事件发生（2．5％），两者比较差异具有统计学意义（P〈0．05）。结论OSAS患者由于长期缺氧易发生动脉硬化，导致脑血流减低和／或脑动脉狭窄。OSAS程度越严重，脑血流动力学异常的发生率也越高，脑血管事件发生的危险性也越大。

The Study of Cerebrovuscular Hemodynamics in Patients with Obstructive Sleep Apnea Syndrome

Objective To investigate the mechanism and the change of Cerebrovascular hemodynamics in patients with obstructive sleep apnea syndrome（OSAS）. Methods 40 cases with OSAS were enrolled in this study. 40 healthy volunteers were detected as the control group. Transcranial Doppler （TCD） was used to examine the flow velocity of the intracranial artery in two groups;stenosis, occlusion, vasospasm and flow spectra were detected at the same time. Results 33 cases（33/40,82.5% ） were found with abnormal cerebrovascular hemodynamics in OSAS group,in which there were 27 cases （67.5%） with reduced flow velocity and 6 cases （ 17.5% ）with cerebral artery stenosis, and 7 cases （ 17.5% ） with abnormal hemodynamics were found in the control group. The incidence of abnormal in OSAS group was higher remarkably than that of control group（Х^2 =48.5 ,P 〈0.01 ）. After one year later,The incidence rates of cerebrovaseular event were 15.0% in OSAS group and 2.5% in control group. There was significant difference between two groups （ P 〈 0. 05 ）. Conclusion The OSAS were more liable to develop arteriosclerosis because of a long period of anoxia, which may lead to vascellum stenosis and/or reduced flow velocity of the intracranial artery. The increased incidence of abnormal cerebral hemodynamics and morbility of cerebrovascular event were followed by aggravated of OSAS.