Shibazaki K, Kimura K, Aoki J, Uemura J, Fujii S, Sakai K
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
Eur J Neurol. 2014 Feb;21(2):344-8. doi: 10.1111/ene.12323. Epub 2013 Dec 7.
Sleep-disordered breathing (SDB) is a risk factor for stroke. The frequency of SDB in Japanese patients with acute intracerebral hemorrhage (ICH) was investigated, as well as factors associated with SDB severity.
Between April 2010 and April 2013, patients with ICH within 24 h of onset were prospectively enrolled to participate in a sleep study within 7 days of admission. SDB was defined as a respiratory disturbance index (RDI: apnea or hypopnea events per hour) of ≥ 5. Patients were assigned to groups based on RDI values of ≥ 30 (severe SDB) and <30 (absent or not severe SDB). The frequency of SDB and factors associated with its severity were investigated using multivariate logistic regression analysis.
Of 97 patients (55 males; mean age 68.1 years) enrolled in the study, 91 (94%) had SDB. Severe SDB was evident in 29 (30%) patients. Compared with the RDI< 30 group, the RDI ≥ 30 group had a higher frequency of dysarthria plus dysphagia (76% vs. 47%, P = 0.008), larger waist circumference [86 (84-92) vs. 84 (78-88) cm, P = 0.019] and a greater body mass index [23.8 (21.1-26.8) vs. 21.5 (19.4-25.0) kg/m(2), P = 0.046]. Multivariate logistic regression analysis showed that dysarthria plus dysphagia was independently associated with severe SDB (odds ratio 3.4; 95% confidence interval 1.250-9.252, P = 0.017).
Most Japanese patients with acute ICH had SDB, and dysarthria plus dysphagia was associated with severe SDB.
睡眠呼吸障碍（SDB）是中风的一个危险因素。本研究调查了日本急性脑出血（ICH）患者中SDB的发生率以及与SDB严重程度相关的因素。
在2010年4月至2013年4月期间，前瞻性纳入发病24小时内的ICH患者，在入院7天内参加睡眠研究。SDB定义为呼吸紊乱指数（RDI：每小时呼吸暂停或呼吸不足事件数）≥5。根据RDI值≥30（严重SDB）和<30（无或不严重SDB）将患者分组。使用多因素逻辑回归分析研究SDB的发生率及其严重程度相关因素。
本研究纳入的97例患者（55例男性；平均年龄68.1岁）中，91例（94%）有SDB。29例（30%）患者有严重SDB。与RDI<30组相比，RDI≥30组构音障碍合并吞咽困难的发生率更高（76%对47%，P = 0.008），腰围更大[86（84 - 92）对84（78 - 88）cm，P = 0.019]，体重指数更高[23.8（21.1 - 26.8）对21.5（19.4 - 25.0）kg/m²，P = 0.046]。多因素逻辑回归分析显示，构音障碍合并吞咽困难与严重SDB独立相关（比值比3.4；95%置信区间1.250 - 9.252，P = 0.017）。
大多数日本急性ICH患者有SDB，构音障碍合并吞咽困难与严重SDB相关。
