急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征患者伴发脑心综合征的临床分析

目的探讨急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生脑心综合征(CCS)的差异性,为临床监测及干预治疗提供依据。方法收集急性脑卒中合并OSAHS患者471例,其中缺血性卒中伴轻度OSAHS组85例,缺血性卒中伴中度OSAHS组74例,缺血性卒中伴重度OSAHS组68例,出血性卒中伴轻度OSAHS组69例,出血性卒中伴中度OSAHS组83例,出血性卒中伴重度OSAHS组92例。观察各组心电图、心肌酶、肌钙蛋白的变化。结果缺血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.532,P=0.012),其中两两比较差异均有统计学意义(P0.01)。出血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=12.741,P=0.005),其中两两比较差异均有统计学意义(P0.01)。缺血性卒中合并轻度OSAHS与出血性卒中合并轻度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.972,P=0.010)。缺血性卒中合并中度OSAHS与出血性卒中合并中度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=9.248,P=0.005)。缺血性卒中合并重度OSAHS与出血性卒中合并重度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=10.831,P=0.005)。结论急性脑卒中合并OSAHS的患者,随着OSAHS程度的加重,CCS的发生率增加,且出血性卒中合并OSAHS的患者较缺血性卒中合并OSAHS的患者更易导致CCS的发生。

Clinical analysis of incidence of cerebro -cardiac syndrome in acute cerebral stroke with obstructive sleep ap-nea hypopnea syndrome

Objective To explore the individual variation of incidence of cerebrocardiac syndrome(CCS)in a-cute cerebral stroke with obstructive sleep apnea hypopnea syndrome (OSAHS),and provide the evidence for clinical monitoring and intervention treatment.Methods Four hundred and seventy -one cases acute cerebral stroke were col-lected,including 85 cases acute ischemic stroke with low -grade OSAHS,74 cases acute ischemic stroke with midrange OSAHS,68 cases acute ischemic stroke with severe OSAHS,and 69 cases acute hemorrhagic stroke with low-grade OS-AHS,83 cases acute hemorrhagic stroke with midrange OSAHS,92 cases acute hemorrhagic stroke with severe OSAHS. The electrocardiogram(ECG),myocardial enzymes,troponin of different groups were observed.Results The incidence of CCS in acute ischemic stroke with different levels of OSAHS was significant difference(χ2 =6.532,P =0.012),and the difference between the any two groups was also statistically significant(P <0.01).The incidence of CCS in acute hemorrhagic stroke with different levels of OSAHS was significant difference(χ2 =12.741,P =0.005),and the differ-ence between the any two groups was also statistically significant(P <0.01).The difference of incidence of CCS was statistically significant (P <0.01)between acute ischemic stroke and acute hemorrhagic stroke with low-grade OSAHS (χ2 =6.972,P =0.010).The difference of incidence of CCS was statistically significant (P <0.01)between acute is-chemic stroke and acute hemorrhagic stroke with midrange OSAHS(χ2 =9.248,P =0.005).The difference of incidence of CCS was statistically significant (P <0.01)between acute ischemic stroke and acute hemorrhagic stroke with severe OSAHS(χ2 =10.831,P =0.005).Conclusion The incidence of CCS increases with the level of OSAHS in acute cere-bral events with OSAHS,acute hemorrhagic stroke with OSAHS can cause CCS more frequently than acute ischemic stroke with OSAHS.