国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2010年
11期
808-812
,共5页
吴波娜%陈晓南%翟登月%陈茂刚%刘文华%魏宁%徐格林%刘新峰
吳波娜%陳曉南%翟登月%陳茂剛%劉文華%魏寧%徐格林%劉新峰
오파나%진효남%적등월%진무강%류문화%위저%서격림%류신봉
睡眠呼吸暂停,阻塞性%颈动脉狭窄%卒中%脑缺血发作,短暂性%血管造影术,数字减影
睡眠呼吸暫停,阻塞性%頸動脈狹窄%卒中%腦缺血髮作,短暫性%血管造影術,數字減影
수면호흡잠정,조새성%경동맥협착%졸중%뇌결혈발작,단잠성%혈관조영술,수자감영
Carotid stenosis%Sleep apnea,obstructive%Stroke%Ischemic attack,transient%Angiography,digital subtraction
目的 探讨缺血性脑血管病(ischemic cerebrovascular disease,ICVD)患者阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)与颈动脉狭窄的关系,为制定颈动脉狭窄的干预策略提供参考.方法 从南京卒中注册系统中筛选出87例ICVD患者,根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)将患者分为无OSAHS组(n=21)以及轻度(n=24)、中度(n=27)和重度(n=11)OSAHS组;另外,根据数字减影血管造影(digital subtraction angiography,DSA)结果,将患者分为无颈动脉狭窄组(n=34)和颈动脉狭窄组(n=49).分析脑血管病危险因素和OSAHS对ICVD患者颈动脉狭窄的影响.结果 无OSAHS以及轻度、中度和重度OSAHS组之间饮酒(χ2=8.56,P=0.036)、高血压(χ2=13.2,P=0.004)和颈动脉狭窄(χ2=22.97,P=0.006)患者比例均存在显著差异.单因素分析显示,年龄(OR=1.066,95% CI 1.023～1.112;P=0.003)、高血压(OR=3.587,95%CI 1.294～9.949;P=0.014)、饮酒(OR=5.275,95%CI 1.855～15.001,P=0.002)和OSAHS(OR=1.073,95%CI 1.033～1.115,P=0.000)是颈动脉狭窄的危险因素;多变量logistic回归分析显示,年龄(OR=1.113,95%CI 1.047～1.182;P=0.001)、OSAHS(OR=1.096,95%CI 1.034～1.160;P=0.000)、饮酒(OR=4.292,95% CI 1.217～15.139;P=0.024)是颈动脉狭窄的独立危险因素.Spearman等级相关分析提示,AHI水平与颈动脉狭窄程度呈正相关(r=0.435,P=0.000).无颈动脉病变组(n=34)、单侧病变组(n=22)和双侧病变组(n=27)AHI存在显著差异[(12.97±10.04)次/h对(21.40±16.38)次/h对(29.33±13.81)次/h,F=11.64,P<0.01].结论 OSAHS是颈动脉狭窄的独立危险因素,且与颈动脉狭窄严重程度呈正相关.AHI在一定程度上能反映颈动脉狭窄程度和颈部血管受累范围.
目的 探討缺血性腦血管病(ischemic cerebrovascular disease,ICVD)患者阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea-hypopnea syndrome,OSAHS)與頸動脈狹窄的關繫,為製定頸動脈狹窄的榦預策略提供參攷.方法 從南京卒中註冊繫統中篩選齣87例ICVD患者,根據呼吸暫停低通氣指數(apnea-hypopnea index,AHI)將患者分為無OSAHS組(n=21)以及輕度(n=24)、中度(n=27)和重度(n=11)OSAHS組;另外,根據數字減影血管造影(digital subtraction angiography,DSA)結果,將患者分為無頸動脈狹窄組(n=34)和頸動脈狹窄組(n=49).分析腦血管病危險因素和OSAHS對ICVD患者頸動脈狹窄的影響.結果 無OSAHS以及輕度、中度和重度OSAHS組之間飲酒(χ2=8.56,P=0.036)、高血壓(χ2=13.2,P=0.004)和頸動脈狹窄(χ2=22.97,P=0.006)患者比例均存在顯著差異.單因素分析顯示,年齡(OR=1.066,95% CI 1.023～1.112;P=0.003)、高血壓(OR=3.587,95%CI 1.294～9.949;P=0.014)、飲酒(OR=5.275,95%CI 1.855～15.001,P=0.002)和OSAHS(OR=1.073,95%CI 1.033～1.115,P=0.000)是頸動脈狹窄的危險因素;多變量logistic迴歸分析顯示,年齡(OR=1.113,95%CI 1.047～1.182;P=0.001)、OSAHS(OR=1.096,95%CI 1.034～1.160;P=0.000)、飲酒(OR=4.292,95% CI 1.217～15.139;P=0.024)是頸動脈狹窄的獨立危險因素.Spearman等級相關分析提示,AHI水平與頸動脈狹窄程度呈正相關(r=0.435,P=0.000).無頸動脈病變組(n=34)、單側病變組(n=22)和雙側病變組(n=27)AHI存在顯著差異[(12.97±10.04)次/h對(21.40±16.38)次/h對(29.33±13.81)次/h,F=11.64,P<0.01].結論 OSAHS是頸動脈狹窄的獨立危險因素,且與頸動脈狹窄嚴重程度呈正相關.AHI在一定程度上能反映頸動脈狹窄程度和頸部血管受纍範圍.
목적 탐토결혈성뇌혈관병(ischemic cerebrovascular disease,ICVD)환자조새성수면호흡잠정저통기종합정(obstructive sleep apnea-hypopnea syndrome,OSAHS)여경동맥협착적관계,위제정경동맥협착적간예책략제공삼고.방법 종남경졸중주책계통중사선출87례ICVD환자,근거호흡잠정저통기지수(apnea-hypopnea index,AHI)장환자분위무OSAHS조(n=21)이급경도(n=24)、중도(n=27)화중도(n=11)OSAHS조;령외,근거수자감영혈관조영(digital subtraction angiography,DSA)결과,장환자분위무경동맥협착조(n=34)화경동맥협착조(n=49).분석뇌혈관병위험인소화OSAHS대ICVD환자경동맥협착적영향.결과 무OSAHS이급경도、중도화중도OSAHS조지간음주(χ2=8.56,P=0.036)、고혈압(χ2=13.2,P=0.004)화경동맥협착(χ2=22.97,P=0.006)환자비례균존재현저차이.단인소분석현시,년령(OR=1.066,95% CI 1.023～1.112;P=0.003)、고혈압(OR=3.587,95%CI 1.294～9.949;P=0.014)、음주(OR=5.275,95%CI 1.855～15.001,P=0.002)화OSAHS(OR=1.073,95%CI 1.033～1.115,P=0.000)시경동맥협착적위험인소;다변량logistic회귀분석현시,년령(OR=1.113,95%CI 1.047～1.182;P=0.001)、OSAHS(OR=1.096,95%CI 1.034～1.160;P=0.000)、음주(OR=4.292,95% CI 1.217～15.139;P=0.024)시경동맥협착적독립위험인소.Spearman등급상관분석제시,AHI수평여경동맥협착정도정정상관(r=0.435,P=0.000).무경동맥병변조(n=34)、단측병변조(n=22)화쌍측병변조(n=27)AHI존재현저차이[(12.97±10.04)차/h대(21.40±16.38)차/h대(29.33±13.81)차/h,F=11.64,P<0.01].결론 OSAHS시경동맥협착적독립위험인소,차여경동맥협착엄중정도정정상관.AHI재일정정도상능반영경동맥협착정도화경부혈관수루범위.
Objective To investigate the relationship between obstructive sleep apneahypopnea syndrome (OSAHS) and carotid stenosis in patients with ischemic cerebrovascular disease (ICVD) and to provide reference for developing the intervention strategy of carotid stenosis. Methods Eighty-seven patients with ICVD were screened from Nanjing Stroke Registry Program. The patients were divided into without (n=21), mild(n=24), moderate (n=27) and severe (n = 11) OSAHS groups according to the apnea-hypopnea index (AHI); in addition, the patients were divided into with (n =34) and without carotid stenosis (n=49) groups according to the results of digital subtraction angiography (DSA). The effects of the risk factors for cerebrovascular diseases and OSAHS on carotid stenosis in patients with ICDV were analyzed.Results There were significant differences in the proportions of alcohol consumption (χ2=8.56, P =0. 036), hypertension (χ2 = 13.20, P =0. 004) and carotid stenosis (χ2 =22.97, P =0. 006) between the no OSAHS and the mild, moderate and severe OSAHS groups. The univariate analysis showed that age (OR = 1. 066, 95% CI 1. 023- 1.112; P = 0. 003),hypertension (OR =3.587, 95% CI 1. 294- 9. 949; P =0. 014), alcohol consumption (OR =5.275,95% CI 1.855-15.001; P= 0.002) and OSAHS (OR= 1.073, 95% CI 1.033-1.115; P = 0. 000) were the risk factors for carotid stenosis. The multivariate logistic regression analysis showed that age (OR = 1. 113, 95% CI 1. 047-1. 182; P =0. 001), OSAHS (OR = 1. 096, 95% CI 1. 034-1. 160; P = 0. 000), and alcohol consumption (OR = 4. 292,95% CI 1. 217-15. 139; P = 0. 024) were the independent risk factors for carotid stenosis.Spearman rank correlation analysis suggested that the AHI levels were positively correlated with the degree of carotid stenosis (r = 0. 435, P = 0. 000). There were significant differences among the without stenosis (n =34), unilateral stenosis (n =22), and bilateral stenosis (n=27)groups (12.97 ± 10.04 vs. 21.40 ± 16.38 vs. 29.33 ± 13.81, F= 11.64, P<0.01).Conclusions OSAHS is an independent risk factor for carotid stenosis and it was positively correlated with the severity of carotid stenosis. AHI may reflect the degree of carotid stenosis and the range of neck vascular involvement to some extent.
