伴有和不伴有睡眠呼吸暂停的急性脑卒中患者的危险因素。

Risk Factors in Acute Stroke Patients With and Without Sleep Apnea.

机构信息

Department of Neurology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.

出版信息

Med Arch. 2021 Dec;75(6):444-450. doi: 10.5455/medarh.2021.75.444-450.

DOI:10.5455/medarh.2021.75.444-450

PMID:35169372

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8802685/

Abstract

BACKGROUND

More than 50% of stroke patients have sleep-disordered breathing (SDB), mostly in the form of obstructive sleep apnea (OSA). SDB represents both a risk factor and a consequence of stroke. The presence of SDB has been linked with the poorer long-term outcome and increased long-term stroke mortality. About 20 to 40% of stroke patients have sleep-wake disorders (SWD), mostly in form of insomnia, excessive daytime sleepiness/fatigue, or hypersomnia (increased sleep needs).

OBJECTIVE

The aim of this study was to analyze the frequency of risk factors in patients with acute stroke and sleep apnea.

METHODS

The study included patients without cognitive impairment or with mild cognitive impairment. The diagnosis of apnea syndrome was made on the basis of the Snoring and Apnea Syndrome Questionnaire, the Epworth Sleep Scale, the Berlin Questionnaire, the Stanford Sleepiness Scale, and the General Sleep Questionnaire. The severity of stroke was assessed by the National Institutes of Health Stroke Scale and the Rankin Disability Scale. Patients with a Glasgow score <8 on the day of neuropsychiatric examination were excluded from the study, as well as patients with epileptic seizures at the onset of stroke, with aphasia, with Mini - mental test <23, with verified previous dementia / cognitive impairment.

RESULTS

There is no statistically significant difference in the age of men and women, both with apnea and without apnea. In patients with apnea, heart disease was in the first place 91.8%, followed by hypertension 86.4%, Body mass index 79.1%, hyperlipidemia 50%, smoking 38.2 % and diabetes mellitus 20.9%. Hypertension was the most common risk factor in patients without apnea 83.6%, followed by heart disease 81.0%, Body mass index 60.9%, hyperlipidemia 48.21%, smoking 28.2 % and diabetes mellitus 20%.

CONCLUSION

Heart diseases, hypertension and body mass index are significantly more frequent in patients with than in patients without sleep apnea.

摘要

背景

超过 50%的中风患者存在睡眠呼吸障碍（SDB），主要表现为阻塞性睡眠呼吸暂停（OSA）。SDB 既是中风的危险因素，也是其后果。SDB 的存在与较差的长期预后和增加的长期中风死亡率有关。约 20%至 40%的中风患者存在睡眠-觉醒障碍（SWD），主要表现为失眠、白天过度嗜睡/疲劳或嗜睡（增加的睡眠需求）。

目的

本研究旨在分析急性中风和睡眠呼吸暂停患者的危险因素频率。

方法

本研究纳入了无认知障碍或仅有轻度认知障碍的患者。呼吸暂停综合征的诊断基于打鼾和呼吸暂停综合征问卷、Epworth 睡眠量表、柏林问卷、斯坦福嗜睡量表和一般睡眠问卷。中风的严重程度通过国立卫生研究院中风量表和 Rankin 残疾量表进行评估。在神经心理检查当天格拉斯哥评分<8 的患者，以及在中风发作时出现癫痫发作、有失语症、简易精神状态检查<23、有确诊的先前痴呆/认知障碍的患者被排除在研究之外。

结果

有呼吸暂停和无呼吸暂停的男性和女性患者的年龄无统计学差异。在有呼吸暂停的患者中，心脏病位列首位（91.8%），其次是高血压（86.4%）、体重指数（79.1%）、高血脂症（50%）、吸烟（38.2%）和糖尿病（20.9%）。在无呼吸暂停的患者中，高血压是最常见的危险因素（83.6%），其次是心脏病（81.0%）、体重指数（60.9%）、高血脂症（48.21%）、吸烟（28.2%）和糖尿病（20%）。