Dyken M E, Somers V K, Yamada T, Ren Z Y, Zimmerman M B
Department of Neurology, Sleep Disorders Center, University of Iowa College of Medicine, Iowa City, 52242, USA.
Stroke. 1996 Mar;27(3):401-7. doi: 10.1161/01.str.27.3.401.
We aimed to prospectively determine whether the incidence of obstructive sleep apnea in patients with recent stroke was significantly different from that of a sex- and age-matched control group with no major medical problems.
We prospectively performed overnight polysomnography in 24 patients with a recent stroke (13 men and 11 women; mean age [+/- SD], 64.6 +/- 10.4 years) and 27 subjects without stroke (13 men and 14 women; mean age, 61.6 +/- 8.8 years). Patients with either ischemic or hemorrhagic stroke were entered into this study. Polysomnographic evaluations were performed within approximately 2 to 5 weeks after each patient's stroke.
Obstructive sleep apnea was found in 10 of 13 men with stroke (77%) and in only 3 of 13 male subjects without stroke (23%) (P=.0169). Seven of 11 women with stroke (64%) had obstructive sleep apnea, while only 2 of 14 female subjects without stroke (14%) had obstructive sleep apnea (P=.0168). For men with stroke, the mean apnea/hypopnea index (+/- SE) was 21.5 +/- 4.2 events per hour, while for male subjects without stroke it was 4.8 +/- 1.8 events per hour (P=.0014). For women with stroke the mean apnea/hypopnea index was 31.6 +/- 8.8 events per hour, while for female subjects without stroke it was 2.9 +/- 1.6 events per hour (P=.0024). The 4-year mortality for patients with stroke was 20.8%. All patients with stroke who died had obstructive sleep apnea.
Patients with stroke have an increased incidence of obstructive sleep apnea compared with normal sex- and age-matched control subjects. Hypoxia and hemodynamic responses to obstructive sleep apnea may have predisposed these patients to stroke.
我们旨在前瞻性地确定近期中风患者中阻塞性睡眠呼吸暂停的发生率与年龄和性别匹配且无重大医疗问题的对照组相比是否存在显著差异。
我们前瞻性地对24例近期中风患者（13例男性和11例女性；平均年龄[±标准差]，64.6±10.4岁）和27例无中风受试者（13例男性和14例女性；平均年龄，61.6±8.8岁）进行了夜间多导睡眠图检查。缺血性或出血性中风患者均纳入本研究。在每位患者中风后约2至5周内进行多导睡眠图评估。
13例中风男性患者中有10例（77%）存在阻塞性睡眠呼吸暂停，而13例无中风男性受试者中仅有3例（23%）存在阻塞性睡眠呼吸暂停（P = 0.0169）。11例中风女性患者中有7例（64%）存在阻塞性睡眠呼吸暂停，而14例无中风女性受试者中仅有2例（14%）存在阻塞性睡眠呼吸暂停（P = 0.0168）。中风男性患者的平均呼吸暂停/低通气指数（±标准误）为每小时21.5±4.2次事件，而无中风男性受试者为每小时4.8±1.8次事件（P = 0.0014）。中风女性患者的平均呼吸暂停/低通气指数为每小时31.6±8.8次事件，而无中风女性受试者为每小时2.9±1.6次事件（P = 0.0024）。中风患者的4年死亡率为20.8%。所有死亡的中风患者均存在阻塞性睡眠呼吸暂停。
与年龄和性别匹配的正常对照组相比，中风患者阻塞性睡眠呼吸暂停的发生率更高。对阻塞性睡眠呼吸暂停的缺氧和血流动力学反应可能使这些患者易患中风。
