Xu Jiewen, Deng Liying, Zou Xueliang, Liu Hao, Yu Ye, Ding Yongmin
Department of Neurology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2012 Sep;32(9):1362-5.
To investigate the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral microbleeds (CMBs) in patients with cerebral infarction.
Consecutive patients with acute cerebral infarction who had cerebral microbleeds shown by susceptibility-weighted imaging (SWI) were enrolled to undergo polysomnography (PSG). The patients were divided into two groups, namely non-OSAHS group with apnea-hypopnea index (AHI) less than 5 and OSAHS group with greater AHI, and the clinical and radiological features of cerebral microbleeds were compared between them.
Forty-nine patients were enrolled in this study, including 27 (55.1%) with both cerebral infarction and OSAHS and 22 (44.9%) with cerebral infarction but not OSAHS. A comparison of the risk factors showed that hypertension, a smoking history, and a history of stroke were more prevalent in patients with OSAHS than in those without OSAHS (P<0.05). The incidences of subclinical stroke in OSAHS and non-OSAHS patients were 37.0% (10/27) and 9.0% (2/22) (P<0.05), respectively. Neurological imaging revealed a greater number of cerebral microbleeds in OSAHS group than in non-OSAHS group (P<0.05). In OSAHS patients, 77.8% of the microbleeds were distributed in cortical-subcortical areas, 55.6% in the basal ganglia area, and 25.9% in the infratentorial area, as compared to the percentages of 50.0%, 40.9% and 50.0% in non-OSAHS patients, respectively (P<0.05). In OSAHS patients, 40.7% also had leukoaraiosis, and 48.1% had two or more causes, as compared to the percentages of 13.6% and 18.2% in non-OSAHS patients, respectively (P<0.05).
OSAHS can be a risk factor for cerebral microbleeds. Patients with both cerebral infarction and OSAHS tend to have greater and more extensive lesions of cerebral microbleeds, more complicated cause of the disease, and a grater likeliness of stroke recurrence.
探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对脑梗死患者脑微出血（CMBs）的影响。
纳入连续的急性脑梗死患者，这些患者经磁敏感加权成像（SWI）显示存在脑微出血，并接受多导睡眠图（PSG）检查。将患者分为两组，即呼吸暂停低通气指数（AHI）小于5的非OSAHS组和AHI较高的OSAHS组，比较两组脑微出血的临床和影像学特征。
本研究共纳入49例患者，其中27例（55.1%）患有脑梗死合并OSAHS，22例（44.9%）患有脑梗死但无OSAHS。危险因素比较显示，OSAHS患者中高血压、吸烟史和卒中史的发生率高于无OSAHS患者（P<0.05）。OSAHS患者和非OSAHS患者亚临床卒中的发生率分别为37.0%（10/27）和9.0%（2/22）（P<0.05）。神经影像学显示，OSAHS组的脑微出血数量多于非OSAHS组（P<0.05）。在OSAHS患者中，77.8%的微出血分布在皮质-皮质下区域，55.6%在基底节区，25.9%在幕下区域，而非OSAHS患者中这一比例分别为50.0%、40.9%和50.0%（P<0.05）。在OSAHS患者中，40.7%还存在脑白质疏松，48.1%有两种或更多病因，而非OSAHS患者中这一比例分别为13.6%和18.2%（P<0.05）。
OSAHS可能是脑微出血的危险因素。脑梗死合并OSAHS的患者往往脑微出血病变更大、更广泛，病因更复杂，卒中复发的可能性更大。
