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目的探讨急性脑梗死伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的睡眠结构与脑梗死严重程度的关系。方法选择2015年1月至2016年4月收治的首发急性脑梗死患者共98例,其中脑梗死合并OSAHS者48例为实验组,不合并OSAHS者50例为对照组。对两组患者进行多导睡眠监测并使用美国国立卫生研究院卒中量表(NIHSS)对脑梗死严重程度进行评价,并对NIHSS评分与睡眠呼吸参数及分期进行相关性检验。结果实验组患者NIHSS评分与夜间平均血氧饱和度(Sa O2)、夜间最低Sa O2、NREM 3+4期呈负相关(P<0.05),与呼吸暂停指数(AHI)、Sa O2减低指数(ODI)、NREM 1+2期呈正相关(P<0.05)。对照组患者NIHSS评分与ODI呈正相关(r=0.378,P<0.05)。结论 OSAHS可能加重急性脑梗死患者的神经功能损伤。
Objective To investigate the relationship between sleep architecture and the severity of cerebral infarction in patients with acute cerebral infarction and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods A total of 98 patients with acute cerebral infarction who were admitted to our hospital from January 2015 to April 2016 were enrolled. Among them, 48 patients with cerebral infarction complicated with OSAHS were the experimental group and 50 patients without OSAHS as control group. Polysomnography was performed on both groups and the severity of cerebral infarction was assessed using the National Institutes of Health Stroke Scale (NIHSS), and the correlation between NIHSS scores and sleep breathing parameters and staging was tested. Results The scores of NIHSS in the experimental group were negatively correlated with the average nighttime oxygen saturation (Sa O2), nighttime lowest Sa O2 and NREM 3 + 4 (P <0.05), but not with the apnea hypopnea index (AHI) ODI) and NREM 1 + 2 (P <0.05). The NIHSS score of the control group was positively correlated with ODI (r = 0.378, P <0.05). Conclusion OSAHS may aggravate neurological impairment in patients with acute cerebral infarction.