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目的睡眠呼吸障碍(Sleep-disordered breathing,SDB)和脑卒中都是一种非常常见的临床问题,两者均有很高的发病率和致残率。最近的流行病学调查表明两者之间存在着密切的相互联系,大量证据表明,睡眠呼吸障碍是脑卒中的一个独立危险因素。睡眠呼吸障碍导致血液凝固性的增高和血液动力学改变进而引起脑灌注的降低。睡眠呼吸障碍引起的血压增高也可以间接增加患脑卒中的危险。短暂性脑供血不足和脑卒中患者中睡眠呼吸暂停的发生率明显增高,脑卒中患者的病死率与卒中的严重程度及呼吸紊乱指数有密切的相关。卒中的严重程度和夜间的最低血氧饱和度可以预测卒中的康复程度。较长的呼吸事件可以增加死亡的危险,上气道梗阻是导致卒中预后不良的重要因素。应该对短暂性脑供血不足和脑卒中患者进行睡眠呼吸暂停事件的筛查。正压通气治疗可以明显改善合并睡眠呼吸暂停脑卒中患者的预后。
Purpose Sleep-disordered breathing (SDB) and stroke are both very common clinical problems, both of which have high rates of morbidity and morbidity. Recent epidemiological studies have shown that there is a close interrelationship between the two, and there is ample evidence that sleep disordered breathing is an independent risk factor for stroke. Sleep disordered breathing leads to increased blood clotting and hemodynamic changes that in turn cause a decrease in cerebral perfusion. Increased blood pressure caused by sleep-disordered breathing can also indirectly increase the risk of stroke. The incidence of transient cerebral insufficiency and sleep apnea in stroke patients was significantly higher. The mortality rate of stroke patients was closely related to the severity of stroke and respiratory disturbance index. The severity of stroke and nighttime oxygen saturation predict the extent of stroke recovery. Longer respiratory events can increase the risk of death and upper airway obstruction is an important factor in the poor prognosis of stroke. Screening for sleep apnea should be performed on patients with transient cerebral insufficiency and stroke. Positive pressure ventilation can significantly improve the prognosis of stroke patients with sleep apnea.