Mei Yuqing, Guo Yanwei, Zhang Min, Yun Wenwei, Xu Gelin
Department of Neurology, Affiliated Jingling Hospital, Nanjing Medical University, Nanjing, 210002, Jiangsu, China.
Depatment of Neurology, Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
Neurol Sci. 2025 Aug 6. doi: 10.1007/s10072-025-08386-2.
Obstructive sleep apnoea (OSA) is a common sleep-related breathing disorder that can negatively affect the prognosis of cardiovascular events. However, OSA may facilitate the development of collateral circulation via hypoxic preconditioning. This study aimed to investigate the relationship between OSA and intracranial collateral circulation among stroke patients with proximal middle cerebral artery (MCA) stenosis or occlusion.
Patients with symptomatic unilateral proximal MCA stenosis or occlusion were enrolled. All patients underwent polygraph and computed tomographic angiography within 72 h of stroke onset. OSA was defined as an apnoea-hypopnoea index (AHI) of ≥ 15 events per hour. The collateral circulation of the MCA was visually assessed via the Tan scoring system and ranged from 0 (no collaterals) to 3 (extensive collaterals).
Among the 78 enrolled patients, 74% were male. The mean age of the participants was 61 ± 12 years. OSA was identified in 40 patients (51.3%). Compared with non-OSA patients, OSA patients presented better intracranial collateral circulation (collateral score ≥ 2, 87.5% vs. 65.8%, P = 0.023). Additionally, patients with good intracranial collateral circulation (collateral score ≥ 2) had a greater AHI than patients with poor intracranial collateral circulation (25.4 ± 17.1 vs. 14.9 ± 13.2, P = 0.02). Spearman's correlation analysis revealed a positive correlation between the AHI and collateral score (r = 0.866, P < 0.01).
OSA may facilitate the development of intracranial collateral circulation in patients with proximal MCA stenosis or occlusion and thus exert protective effects among patients with acute cerebral infarction.
阻塞性睡眠呼吸暂停（OSA）是一种常见的与睡眠相关的呼吸障碍，可对心血管事件的预后产生负面影响。然而，OSA可能通过缺氧预处理促进侧支循环的形成。本研究旨在探讨近端大脑中动脉（MCA）狭窄或闭塞的卒中患者中OSA与颅内侧支循环之间的关系。
纳入有症状的单侧近端MCA狭窄或闭塞患者。所有患者在卒中发作后72小时内接受多导睡眠监测和计算机断层血管造影。OSA定义为呼吸暂停低通气指数（AHI）≥每小时15次事件。通过Tan评分系统对MCA的侧支循环进行视觉评估，范围从0（无侧支）到3（广泛侧支）。
在78例纳入患者中，74%为男性。参与者的平均年龄为61±12岁。40例患者（51.3%）被诊断为OSA。与非OSA患者相比，OSA患者的颅内侧支循环更好（侧支评分≥2，87.5%对65.8%，P = 0.023）。此外，颅内侧支循环良好（侧支评分≥2）的患者AHI高于颅内侧支循环差的患者（25.4±17.1对14.9±13.2，P = 0.02）。Spearman相关性分析显示AHI与侧支评分之间存在正相关（r = 0.866，P < 0.01）。
OSA可能促进近端MCA狭窄或闭塞患者颅内侧支循环的形成，从而对急性脑梗死患者发挥保护作用。
