阻塞性睡眠呼吸暂停与觉醒型卒中的关系分析

目的讨论阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与觉醒型卒中(wake-up stroke,WUS)的关系。方法回顾性分析伴阻塞性睡眠呼吸暂停低通气综合征的急性缺血性卒中患者资料,患者均接受夜间睡眠监测检查,分为WUS组和非WUS组,比较两组间一般临床资料、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分及睡眠呼吸参数等指标的差异。结果共入组96例患者,其中WUS组22例,非WUS组74例,WUS组的体质指数(body mass index,BMI)(P=0.030)、呼吸暂停低通气指数(apnea-hypopnea index,AHI)(P=0.001)、血氧饱和度下降指数(oxygen desaturation index,ODI)(P=0.001)均显著高于非WUS组,平均血氧饱和度(P=0.002)显著低于非WUS组;Logistic回归分析显示,AHI增高[比值比(odds ratio,OR)1.162,95%可信区间(confidence interval,CI)1.007~1.341]是WUS的独立危险因素。结论 BMI、AHI、ODI和平均血氧饱和度与阻塞性睡眠呼吸暂停低通气综合征患者发生WUS有关,其中AHI是WUS的独立危险因素。

Correlation Analysis of Obstructive Sleep Apnea and Wake-up Stroke

Objective To explore the relationship between obstructive sleep apnea (OSA) and wake-up stroke (WUS).
Methods The clinical data of patients with ischemic stroke accompanied with OSA were analyzed retrospectively. The patients received sleep monitoring examination at night and were divided into WUS group and non wake-up stroke (non-WUS) group. The differences of the clinical data, National Institutes of Health Stroke Scale (NIHSS) score, etiology and the slee respiratory parameters were compared between the two groups.
Results A total of 96 patients were included, among whom, there was 74 cases in non-WUS group and 22 cases in WUS group. The body mass index (BMI) (P=0.030), apnea-hypopnea index (AHI) (P=0.001), and oxygen desaturation index (ODI) (P=0.001) in WUS group were higher than those in non-WUS group. The mean blood pulse oxyhemoglobin saturation (P=0.002) in WUS group was lower than which in non-WUS group. Binary logistic regression analysis indicated that the independent risk factor for WUS was AHI (odds ratio [OR] 1.162, 95% conifdence interval [CI] 1.007~1.341).
Conclusion BMI, AHI, ODI and mean blood pulse oxyhemoglobin saturation are associated with WUS. AHI is an independent risk factor for WUS.