Hu Jie, Zhang Jie, Huang Qian, Chen Qi-Dong, Jin Min, Dong Ke-Hui
Department of Pulmonary Medicine, Beijing Tiantan Hospital Affiliated to Capital University of Medical Science, Beijing, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Dec;30(12):904-7.
To evaluate the relationship between vertebrobasilar ischemia (VBI) and sleep apnea hypopnea syndrome (SAHS) and the effect of percutaneous transluminal stenting for VBI on the clinical parameters of SAHS.
Twenty patients with VBI were included for clinical history, physical examination with sleep quentionnaires and scored by the Epworth Sleepiness Scale (ESS). Polysomnographic (PSG) studies were performed before and after vascular stenting for VBI. The relationship among clinical factors, the incidence and characteristics of SAHS were analyzed. The changes of apnea hypopnea index (AHI), longest apnea duration (LAD), the total time of apnea and hypopnea (AH%), the lowest arterial saturation (LSaO(2)) and oxygen desaturation index (ODI(4)) before and after vascular stenting were compared.
PSG studies were performed in 20 cases of VBI. SAHS was confirmed in 17 of the 20 patients, including mild (10/20), moderate (3/20) and severe (4/20), all were of obstructive. Before stenting therapy, AHI was 11.3/h (6.3 - 23.6)/h, but was 5.0/h (1.6 - 12.7)/h after therapy. LAD was (31.5 +/- 18.6) s vs (19.5 +/- 12.4) s, LSaO2 was (83.6 +/- 7.1)% vs (86.1 +/- 3.3)%, the AH% was [2.3 (0.6% - 9.8)%] vs [6.9% (2.6 - 14.3)%], ODI(4) was 10.1/h (5.3 - 29.0)/h vs 5.8/h (2.7 - 17.0)/h, respectively before and after stenting. AHI, LAD and ODI(4) were significantly decreased and LSaO(2) was increased after stenting for VBI.
This series of patients with cerebravascular ischemia caused by vertebrobasilar artery stenosis had a high prevalence of obstructive sleep apnea. Vertebrobasilar vascular stenting was shown to be a reliable method of decreasing the degree of sleep-disordered breathing and hypoxia for SAHS patients with vertebrobasilar artery stenosis.
评估椎基底动脉供血不足（VBI）与睡眠呼吸暂停低通气综合征（SAHS）之间的关系，以及经皮腔内血管成形术治疗VBI对SAHS临床参数的影响。
纳入20例VBI患者，进行临床病史采集、体格检查并填写睡眠问卷，采用爱泼华嗜睡量表（ESS）评分。在对VBI进行血管支架置入术前、后进行多导睡眠图（PSG）检查。分析临床因素、SAHS的发病率及特征之间的关系。比较血管支架置入术前、后呼吸暂停低通气指数（AHI）、最长呼吸暂停时间（LAD）、呼吸暂停和低通气总时间（AH%）、最低动脉血氧饱和度（LSaO₂）及氧减指数（ODI₄）的变化。
对20例VBI患者进行了PSG检查。20例患者中17例确诊为SAHS，其中轻度（10/20）、中度（3/20）和重度（4/20），均为阻塞性。支架置入术前，AHI为11.3次/小时（6.3 - 23.6次/小时），术后为5.0次/小时（1.6 - 12.7次/小时）。LAD分别为（31.5±18.6）秒和（19.5±12.4）秒，LSaO₂分别为（83.6±7.1）%和（86.1±3.3）%，AH%分别为[2.3（0.6% - 9.8）%]和[6.9%（2.6 - 14.3）%]，ODI₄分别为10.1次/小时（5.3 - 29.0次/小时）和5.8次/小时（2.7 - 17.0次/小时）。VBI支架置入术后，AHI、LAD和ODI₄显著降低，LSaO₂升高。
这组由椎基底动脉狭窄导致脑血管缺血的患者中，阻塞性睡眠呼吸暂停的患病率较高。对于患有椎基底动脉狭窄的SAHS患者，椎基底动脉血管支架置入术是一种降低睡眠呼吸紊乱程度和缺氧程度的可靠方法。
