Smirne S, Palazzi S, Zucconi M, Chierchia S, Ferini-Strambi L
Dept of Neurology, State University, Milano, Italy.
Eur Respir J. 1993 Oct;6(9):1357-61.
We wanted to assess habitual snoring as a credible risk factor for acute vascular disease, mainly stroke and myocardial infarction. The patients selected for the study had been admitted to the hospital through the emergency department, and were evaluated by means of multidimensional interviews and clinical records: 164 had acute cerebrovascular disease, and 136 cardiovascular disease; 330 patients with nonvascular disease were the controls. The evaluation showed 48% of vascular disease patients to be habitual snorers, but only 30% of the controls; the difference was statistically significant. Compared with the controls, in the cerebrovascular patients the risk (odds ratio) associated with habitual snoring was significantly increased, and of the same order as the risk associated with age over 65 yrs, male gender, diabetes mellitus, and dyslipidaemia; whilst the risk associated with hypertension was higher. In the cardiovascular patients, the risk associated with habitual snoring was again significantly increased and of the same order as the risk associated with male gender, body mass index > 29 (kg.m-2), dyslipidaemia, heavy smoking, excessive alcohol intake and hypertension. A logistic regression analysis, entering the variables in the following order: age, gender, body mass index, diabetes, dyslipidaemia, smoking, alcohol, hypertension, and habitual snoring, showed that habitual snoring carries a significant risk factor for stroke and myocardial infarction, even after adjusting for other factors. Since habitual snoring carries a definite risk for acute vascular disease, we conclude that inquiring about it should become routine practice.
我们想要评估习惯性打鼾作为急性血管疾病(主要是中风和心肌梗死)的一个可靠风险因素。入选该研究的患者是通过急诊科入院的,并通过多维访谈和临床记录进行评估:164例患有急性脑血管疾病,136例患有心血管疾病;330例非血管疾病患者作为对照。评估显示,48%的血管疾病患者为习惯性打鼾者,而对照组中这一比例仅为30%;差异具有统计学意义。与对照组相比,在脑血管疾病患者中,习惯性打鼾相关的风险(优势比)显著增加,与65岁以上、男性、糖尿病和血脂异常相关的风险处于同一水平;而与高血压相关的风险更高。在心血管疾病患者中,习惯性打鼾相关的风险再次显著增加,与男性、体重指数>29(kg·m²)、血脂异常、重度吸烟、过量饮酒和高血压相关的风险处于同一水平。一项逻辑回归分析,按照以下顺序纳入变量:年龄、性别、体重指数、糖尿病、血脂异常、吸烟、饮酒、高血压和习惯性打鼾,结果显示,即使在对其他因素进行调整后,习惯性打鼾仍是中风和心肌梗死的一个显著风险因素。由于习惯性打鼾对急性血管疾病具有明确风险,我们得出结论,询问患者是否习惯性打鼾应成为常规做法。