不同部位不同面积脑梗死与阻塞性睡眠呼吸暂停综合征的关系

摘要

目的 观察脑梗死患者合并阻塞性睡眠呼吸暂停低通气综合征(OSAS)的梗死面积和部位的变化,并探讨其与OSAS的关系.方法 收集2015年7月至2017年4月在本院神经内科治疗并完成睡眠多导监测的6h～3w脑梗死患者200例.根据神经影像学检查分为:前循环梗死组(n=146)和后循环梗死组(n=54),大面积(≥5 cm) 47例、非大面积(2～5cm及＜2 cm)153例,并根据呼吸暂停低通气指数(AHI)将200例脑梗死患者进行分组,单纯脑梗死组(n=89)及脑梗死合并OSAS组(n=111).对所有研究对象进行一般情况、脑梗死部位、脑梗死面积、NIHSS评分(美国国立卫生研究院卒中量表)、睡眠参数方而的检测,采用SPSS22.0软件进行数据分析.结果 单纯脑梗死组其梗死部位在前循环的有63例(70.8％),脑梗死合并轻度OSAS梗死部位在前循环的有40例(80.0％),合并中度OSAS梗死部位在前循环的有25例(75.8％),合并重度OSAS梗死部位在前循环的有18例(64.3％),四组前后循环中占比比较差异均无统计学意义(均P＞ 0.05).大面积梗死脑梗死组及脑梗死合并OSAS组分别为20例(22.5％)、27例(24.3％),非大面积梗死脑梗死组及脑梗死合并OSAS组分别为69例(77.5％)、84例(75.7％),差异均无统计学意义(均P＞ 0.05).结论 脑梗死的部位、面积与OSAS的严重程度可能无关.%Objective To observe the changes of the area and part of infarction in patients with cerebral infarction complicating by obstructive sleep apnea syndrome (OSAS),and investigate their relationship with OSAS.Methods 200 stroke patients were recruited out of department of neurology of our hospital from July 2015 to April 2017,all patients were monitored with polysomnography for 6 hours to 3 weeks.All patients were divided into stroke group (n=89) and stroke with OSAS group (n=l 11) according to the apnea hypopnea index (AHI),or anterior-circulation infarction group (n=146) and posterior-circulation infarction group (n=54),or large area infarction group (infarction area ≥5 cm,n=47) and non-large area infarction group (infarction area ＜5 cm,n=153).The general condition,the part of infarction,the area of infarction,NIHSS score,sleep parameters of all patients were recorded.Statistical tests were implemented with IBM SPSS22.0.Results There were 63 patients with anterior-circulation infarction (70.8％) in stroke group;there were 40 patients with anterior-circulation infarction (80.0％) in stroke with mild OSAS group;there were 25 patients with anterior-circulation infarction (75.8％) in stroke with moderate OSAS group;there were 18 patients with anterior-circulation infarction (64.3％) in stroke with severe OSAS group;there was no statistically significant difference in the ratio of anteriorcirculation infarction among the four groups (P＞0.05).There were 20 patients with cerebral infarction (22.5％) and 27 patients with cerebral infarction complicating by OSAS (24.3％) in large area infarction group;there were 69 patients with cerebral infarction (77.5％) and 84 patients with cerebral infarction complicating by OSAS (75.7％) in non-large area infarction group;there was no statistically significant difference (P＞0.05).Conclusion The area and part of cerebral infarction may not be related to the severity of OSAS.