中风后睡眠呼吸紊乱的性别差异：BASIC 项目的研究结果。
Sex differences in sleep-disordered breathing after stroke: results from the BASIC project.
机构信息
University of Michigan Stroke Program, Cardiovascular Center, 3rd Floor, Reception C, 1500 East Medical Center Drive, SPC 5855, Ann Arbor, MI 48109-5855, USA.
University of Michigan Stroke Program, Cardiovascular Center, 3rd Floor, Reception C, 1500 East Medical Center Drive, SPC 5855, Ann Arbor, MI 48109-5855, USA.
出版信息
Sleep Med. 2018 Mar;43:54-59. doi: 10.1016/j.sleep.2017.11.1129. Epub 2017 Dec 6.
OBJECTIVE/BACKGROUND: Sleep-disordered breathing (SDB), an independent risk factor for stroke, is associated with worse post-stroke outcomes. Differences in the relationship between SDB and stroke may exist for women versus men. In this population-based study, we compared the prevalence of both pre- and post-stroke SDB by sex. We also explored whether menopausal status is related to post-stroke SDB.
PATIENTS/METHODS: We performed a cross-sectional study of subjects enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Each subject (n = 1815) underwent a baseline interview including the Berlin Questionnaire to assess pre-stroke SDB risk and, if relevant, questions regarding menopausal status. Subjects were offered overnight SDB screening with a validated portable respiratory device (n = 832 with complete data). Log Poisson and linear regression models were used to assess the differences in SDB between men and women with adjustment for demographics, stroke risk factors, stroke severity, and other potential confounders.
RESULTS
Women were less likely than men to be at high risk for pre-stroke SDB (56.6% versus 61.9%) (prevalence ratio [PR] 0.87 for women; 95% confidence interval [CI], 0.81-0.95). A lower proportion of women than men (50.8% versus 70.2%) had post-stroke SDB by respiratory monitoring (PR 0.71; 95% CI, 0.63-0.80). SDB severity was higher for men than for women (mean difference in respiratory event index [REI] 6.5; 95% CI, 4.3-8.7). No significant association existed between post-stroke SDB and either menopausal status or age at menopause.
CONCLUSIONS
After acute ischemic stroke, SDB was more prevalent and more severe in men than in women.
目的/背景：睡眠呼吸障碍（SDB）是中风的独立危险因素，与中风后预后较差有关。SDB 与中风之间的关系在女性和男性中可能存在差异。在这项基于人群的研究中，我们比较了男女之间中风前和中风后 SDB 的患病率。我们还探讨了绝经状态是否与中风后 SDB 有关。
患者/方法：我们对参与 Brain Attack Surveillance in Corpus Christi（BASIC）项目的受试者进行了横断面研究。每位受试者（n=1815）接受了基线访谈，包括柏林问卷，以评估中风前 SDB 风险，如果相关，还包括关于绝经状态的问题。向受试者提供了经过验证的便携式呼吸设备进行夜间 SDB 筛查（n=832 例，数据完整）。使用对数泊松和线性回归模型评估 SDB 在男性和女性之间的差异，并根据人口统计学、中风危险因素、中风严重程度和其他潜在混杂因素进行调整。
结果
女性发生中风前 SDB 的风险低于男性（56.6%比 61.9%）（女性的患病率比[PR]为 0.87；95%置信区间[CI]，0.81-0.95）。通过呼吸监测，女性中风后 SDB 的比例低于男性（50.8%比 70.2%）（PR 为 0.71；95%CI，0.63-0.80）。男性的 SDB 严重程度高于女性（呼吸事件指数[REI]的平均差异为 6.5；95%CI，4.3-8.7）。绝经状态或绝经年龄与中风后 SDB 之间没有显著关联。
结论
急性缺血性中风后，SDB 在男性中比女性更常见且更严重。
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