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睡眠呼吸暂停与芬兰缺血性脑卒中患者短期预后的关系。

Relationship between SDB and short-term outcome in Finnish ischemic stroke patients.

机构信息

Unit of Neurology, Satakunta Hospital District, Pori, Finland.

Division of Pharmacology and Pharmacotherapy, University of Helsinki, Helsinki, Finland.

出版信息

Brain Behav. 2020 Oct;10(10):e01762. doi: 10.1002/brb3.1762. Epub 2020 Sep 2.

Abstract

OBJECTIVES

Presence of sleep-disordered breathing (SDB) affects negatively recovery from stroke. The aim of this study is to evaluate the relationships between sleep-disordered breathing (SDB) and outcome measures in Finnish stroke unit cohort: mRS, need of rehabilitation and hospitalization time.

MATERIAL AND METHODS

An observational longitudinal study consisted of 95 patients referred to the Stroke Unit of Satakunta Hospital District over a period of November 2013 to March 2016. Patients were tested for SDB within 72 hr from the hospital admission because of ischemic stroke or TIA. The patients underwent polysomnography with NOX T3 wireless recorder.

RESULTS

There are 37% (n = 35) non-OSA patients, 20% (n = 19) of patients have mild obstructive sleep apnea (OSA) and 39% (n = 37) have moderate/severe OSA and 4% (n = 4) have CSA. Patients with OSA have higher proportion of disability scores of mRS 3-5 (38%) compared to non-OSA (11%) and mild OSA (5%) patients on registration day (mRS0), and the same trend is seen at hospital discharge 35% versus 9% and 5%. (p = .009). Proportion of patients with OSA who needed rehabilitation is 65% (n = 19) versus non-OSA patients 17.5% (n = 4) and mild OSA patients 17.5% (n = 4; p = .039). We observed longer duration of hospitalization (5-15 days) in 29% of OSA patients compared to mild OSA patients 47% and OSA patients 54%. (p = .045).

CONCLUSION

Ischemic stroke patients with OSA have higher disability, higher need of rehabilitation, and longer hospitalization length. Prescreening tools for recognizing these stroke patients in acute phase could be valuable. That could result in earlier initiation of treatment and might prevent worse recovery from stroke.

摘要

目的

睡眠呼吸障碍(SDB)的存在会对中风后的恢复产生负面影响。本研究旨在评估芬兰中风单元队列中睡眠呼吸障碍(SDB)与结局测量指标之间的关系:mRS、康复需求和住院时间。

材料和方法

这是一项观察性纵向研究,纳入了 2013 年 11 月至 2016 年 3 月期间入住萨塔昆塔医院区中风单元的 95 例患者。由于缺血性中风或 TIA,患者在入院后 72 小时内接受睡眠呼吸暂停测试。患者使用 NOX T3 无线记录仪进行多导睡眠图检查。

结果

37%(n=35)的患者无阻塞性睡眠呼吸暂停(OSA),20%(n=19)的患者为轻度阻塞性睡眠呼吸暂停(OSA),39%(n=37)的患者为中重度 OSA,4%(n=4)的患者为中枢性睡眠呼吸暂停(CSA)。在登记日(mRS0)时,患有 OSA 的患者 mRS 评分 3-5 的比例较高(38%),而非 OSA(11%)和轻度 OSA(5%)患者;在出院时,这一趋势分别为 35%、9%和 5%(p=0.009)。需要康复的 OSA 患者比例为 65%(n=19),而非 OSA 患者为 17.5%(n=4),轻度 OSA 患者为 17.5%(n=4;p=0.039)。我们观察到 OSA 患者的住院时间(5-15 天)更长,占 29%,而轻度 OSA 患者占 47%,OSA 患者占 54%(p=0.045)。

结论

患有 OSA 的缺血性中风患者残疾程度更高、康复需求更高、住院时间更长。在急性期识别这些中风患者的筛查工具可能具有价值。这可能导致更早开始治疗,并可能防止中风后恢复情况恶化。

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