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目的研究缺血性卒中患者阻塞性睡眠呼吸暂停和颈动脉硬化的关系。方法收集2007年1～8月上海交通大学新华医院神经内科43例缺血性卒中患者,根据颈动脉斑块及内膜中层厚度(IMT)超声检查结果,分为颈动脉硬化组和正常组,同时用多导睡眠监测仪(PSG)监测,记录睡眠呼吸紊乱指数(AHI)、平均氧分压(SaO2)、夜间最低SaO2、SaO2<90%时间、氧减指数即氧减饱和4%以上的次数和已知动脉粥样硬化危险因素(高血压、体重指数、糖尿病、高脂血症、吸烟等)。结果颈动脉硬化组患者中阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发生率明显高于非颈动脉硬化组(P=0.022),睡眠监测指标AHI、SaO2<90%时间、氧减指数与颈动脉IMT呈正相关,夜间最低SaO2、平均SaO2与颈动脉IMT呈负相关。结论OSAHS是缺血性脑卒中患者动脉粥样硬化的独立影响因素。
Objective To study the relationship between obstructive sleep apnea and carotid atherosclerosis in patients with ischemic stroke. Methods 43 ischemic stroke patients were collected from Department of Neurology, Xinhua Hospital, Shanghai Jiao Tong University from January to August 2007. According to the results of carotid plaque and intima - media thickness (IMT), the patients were divided into carotid atherosclerosis group and normal group, At the same time, polysomnography (PSG) was used to monitor and record sleep disturbance index (AHI), mean oxygen partial pressure (SaO2), nighttime SaO2, SaO2 <90% Frequency and known risk factors for atherosclerosis (hypertension, body mass index, diabetes, hyperlipidemia, smoking, etc.). Results The incidence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with carotid atherosclerosis was significantly higher than that in non-carotid arteriosclerosis patients (P = 0.022), sleep monitoring index AHI, SaO2 <90% Carotid IMT was positively correlated with nighttime lowest SaO2 and mean SaO2 negatively correlated with carotid IMT. Conclusion OSAHS is an independent factor of atherosclerosis in patients with ischemic stroke.