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目的::分析睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)合并卒中患者的血清炎性标志物和血管内皮功能指标的表达水平,并探讨与SAS发生卒中相关的危险因素。方法::研究对象包括35例单纯SAS患者以及38例SAS合并卒中的患者。检测并比较2组患者血清内皮型一氧化氮合酶、丙二醛和肿瘤坏死因子α的表达水平。分析与SAS患者发生卒中相关的危险因素。结果::SAS合并卒中患者的血清内皮型一氧化氮合酶、丙二醛和肿瘤坏死因子α水平均显著高于单纯SAS患者(P值均=0.000)。单因素分析结果显示,性别(P=0.012)、年龄(P=0.009)、SAS病程(P=0.000)和高血压病史(P=0.000)均与SAS合并卒中相关;多因素分析结果显示,SAS病程[风险比为9.12(95%可信区间:2.15~13.88),P=0.000]和高血压病史[风险比为5.05(95%可信区间:2.74~10.52),P=0.000]是SAS合并卒中的独立影响因素。结论::SAS合并卒中患者的血清炎性标志物和血管内皮功能指标的表达水平显著升高,提示内皮功能损害进一步加重。SAS病程>1年和有高血压病史的SAS患者更易发生卒中。
OBJECTIVE :: To analyze the expression of serum inflammatory markers and vascular endothelial function in patients with sleep apnea syndrome (SAS) complicated with stroke and to explore the risk factors associated with stroke in SAS. METHODS :: Subjects included 35 patients with simple SAS and 38 patients with SAS complicated with stroke. The levels of serum endothelial nitric oxide synthase, malondialdehyde and tumor necrosis factor alpha in two groups were detected and compared. Risk factors associated with stroke in SAS patients were analyzed. Results: Serum levels of endothelium-derived nitric oxide synthase, malondialdehyde and tumor necrosis factor alpha in SAS patients with stroke were significantly higher than those in patients with SAS alone (P = 0.000). Univariate analysis showed that gender (P = 0.012), age (P = 0.009), SAS course of disease (P = 0.000) and history of hypertension (P = 0.000) were associated with stroke complicated by SAS. Multivariate analysis showed SAS The odds ratio was 9.12 (95% confidence interval: 2.15-13.88, P = 0.000), and a history of hypertension (hazard ratio 5.05 (95% confidence interval: 2.74-10.52), P = 0.000] Stroke independent factors. Conclusion: The expression of serum inflammatory markers and vascular endothelial function indexes in patients with SAS complicated with stroke is significantly increased, suggesting that the endothelial dysfunction is further aggravated. Patients with SAS disease> 1 year and those with a history of hypertension are more prone to stroke.