卒中与 TIA 后睡眠呼吸障碍的患病率：一项荟萃分析。

Prevalence of sleep-disordered breathing after stroke and TIA: A meta-analysis.

机构信息

From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland.

出版信息

Neurology. 2019 Feb 12;92(7):e648-e654. doi: 10.1212/WNL.0000000000006904. Epub 2019 Jan 11.

DOI:10.1212/WNL.0000000000006904

PMID:30635478

Abstract

OBJECTIVE

To perform a systematic review and meta-analysis on the prevalence of sleep-disordered breathing (SDB) after stroke.

METHODS

We searched PubMed, Embase (Ovid), the Cochrane Library, and CINAHL (from their commencements to April 7, 2017) for clinical studies reporting prevalence and/or severity of SDB after stroke or TIA. Only sleep apnea tests performed with full polysomnography and diagnostic devices of the American Academy of Sleep Medicine categories I-IV were included. We conducted random-effects meta-analysis. PROSPERO registration number: CRD42017072339.

RESULTS

The initial search identified 5,211 publications. Eighty-nine studies (including 7,096 patients) met inclusion criteria. Fifty-four studies were performed in the acute phase after stroke (after less than 1 month), 23 studies in the subacute phase (after 1-3 months), and 12 studies in the chronic phase (after more than 3 months). Mean apnea-hypopnea index was 26.0/h (SD 21.7-31.2). Prevalence of SDB with apnea-hypopnea index greater than 5/h and greater than 30/h was found in 71% (95% confidence interval 66.6%-74.8%) and 30% (95% confidence interval 24.4%-35.5%) of patients, respectively. Severity and prevalence of SDB were similar in all examined phases after stroke, irrespective of the type of sleep apnea test performed. Heterogeneity between studies ( ) was mostly high.

CONCLUSION

The high prevalence of SDB after stroke and TIA, which persists over time, is important in light of recent studies reporting the (1) feasibility and (2) efficacy of SDB treatment in this clinical setting.

摘要

目的

系统评价和荟萃分析卒中后睡眠呼吸障碍（SDB）的患病率。

方法

我们检索了 PubMed、Embase（Ovid）、Cochrane 图书馆和 CINAHL（从其开始至 2017 年 4 月 7 日），以获取报告卒中或 TIA 后 SDB 患病率和/或严重程度的临床研究。仅纳入使用全睡眠多导图和美国睡眠医学学会类别 I-IV 诊断设备进行的睡眠呼吸暂停试验。我们进行了随机效应荟萃分析。PROSPERO 注册号：CRD42017072339。

结果

最初的搜索确定了 5211 篇文献。89 项研究（包括 7096 例患者）符合纳入标准。54 项研究在卒中后急性期（1 个月内）进行，23 项在亚急性期（1-3 个月后）进行，12 项在慢性期（3 个月后）进行。平均呼吸暂停低通气指数为 26.0/h（SD 21.7-31.2）。呼吸暂停低通气指数大于 5/h 和大于 30/h 的 SDB 患病率分别为 71%（95%置信区间 66.6%-74.8%）和 30%（95%置信区间 24.4%-35.5%）。无论进行何种睡眠呼吸暂停试验，卒中后各检查阶段 SDB 的严重程度和患病率均相似。研究之间的异质性（）主要较高。