伴有阻塞性睡眠呼吸暂停低通气综合征的脑梗死患者血同型半胱氨酸的变化
반유조새성수면호흡잠정저통기종합정적뇌경사환자혈동형반광안산적변화
Plasma homocyeteine levels in ischemic stroke patients with obstructive sleep apnea
  • 万方数据
    中华医学杂志 중화의학잡지
    National Medical Journal of China
    2011年 25期 1753-1756 ,共4页

    陈茂刚%朱武生%殷勤%吴波娜%王启章%马敏敏%刘德志%李永坤%刘朝来%黄显军%陈兆耀%王万相%徐格林%刘新峰

    진무강%주무생%은근%오파나%왕계장%마민민%류덕지%리영곤%류조래%황현군%진조요%왕만상%서격림%류신봉

    脑梗死%缺血性卒中%睡眠呼吸暂停%同型半胱氨酸 腦梗死%缺血性卒中%睡眠呼吸暫停%同型半胱氨痠
    뇌경사%결혈성졸중%수면호흡잠정%동형반광안산
    Ischemic stroke%Homocysteine%Obstructive sleep apnea syndrome%Polysomnography
    目的 探讨脑梗死伴随阻塞性睡眠呼吸暂停低通气综合征(OSA)患者的血同型半胱氨酸(Hcy)的水平变化.方法 从南京卒中注册系统中筛选2009年3-12月男性急性脑梗死患者,共92例,根据呼吸暂停加低通气指数(AHI)值将病例为无OSA组(AHI＜5/h)与伴OSA组(AHI≥5/h)两组,在脑梗死发病后第(14±2)天检查多导睡眠图与血Hey等生化指标.结果 脑梗死伴OSA组患者的血Hcy水平为(17±5)μmol/L,显著高于无OSA组(11±3)μmol/L(P＜0 01).根据AHI值,将所有病例分为无OSA组(AHI 5～14/h)、轻度OSA组(AHI 5～14/h)、中度OSA组(AHI 15～30/h)和重度OSA(AHI＞30/h),四组的血Hcy分别为(11±3)μmol/L、(14±3)μmol/L、(17±5)μmol/L和(21±5)μmol/L,差异有统计学意义(P＜0.01),进一步组问两两比较,无OSA组均显著低于其他三组(P＜0 05).将血Hcy与AHI作Pearson相关分析,显示Hcy与AHI呈现正相关(r=0 482,P＜0 01).多元线性回归模型校正其他因素后,仍显示AHI(β=0 671,P=0.001)是血Hcy 水平的独立预测因子(R2=0.539,P＜0.01).结论 在脑梗死患者合并OSA时Hcy具有升高趋势,且随着阻塞程度的进展而加重.
    목적 탐토뇌경사반수조새성수면호흡잠정저통기종합정(OSA)환자적혈동형반광안산(Hcy)적수평변화.방법 종남경졸중주책계통중사선2009년3-12월남성급성뇌경사환자,공92례,근거호흡잠정가저통기지수(AHI)치장병례위무OSA조(AHI＜5/h)여반OSA조(AHI≥5/h)량조,재뇌경사발병후제(14±2)천검사다도수면도여혈Hey등생화지표.결과 뇌경사반OSA조환자적혈Hcy수평위(17±5)μmol/L,현저고우무OSA조(11±3)μmol/L(P＜0 01).근거AHI치,장소유병례분위무OSA조(AHI 5～14/h)、경도OSA조(AHI 5～14/h)、중도OSA조(AHI 15～30/h)화중도OSA(AHI＞30/h),사조적혈Hcy분별위(11±3)μmol/L、(14±3)μmol/L、(17±5)μmol/L화(21±5)μmol/L,차이유통계학의의(P＜0.01),진일보조문량량비교,무OSA조균현저저우기타삼조(P＜0 05).장혈Hcy여AHI작Pearson상관분석,현시Hcy여AHI정현정상관(r=0 482,P＜0 01).다원선성회귀모형교정기타인소후,잉현시AHI(β=0 671,P=0.001)시혈Hcy 수평적독립예측인자(R2=0.539,P＜0.01).결론 재뇌경사환자합병OSA시Hcy구유승고추세,차수착조새정도적진전이가중.
    Objective To investigate the association of plasma homocysteine and OSA (obstructive sleep apnea) syndrome in ischemic stroke (IS) . Methods A total of 92 male IS patients were classified by apnea hypopnea index (AHI) into 2 groups: non-OSA group (AHI＜5/h) and OSA group (AHI≥5). All patients were tested for plasma homocysteine when polysomnography was finished at (14±2) d after the onset of IS. Results The mean level of homocysteine was significantly higher in the OSA group than that in the non-OSA group (17±5 vs 11±3μmol/L, P＜0.01). Pearson correlation analysis revealed a positive correlation between the homocysteine level and the severity of AHI (r=0.482, P＜0.01). Further multiple linear regression analysis showed that AHI and folate were independent predictors of homocysteine level (R2=0.553, P＜0.01, β for AHI=0.671, β for folate=-0.256). Conclusion The severity of OSA is significantly associated with an elevated level of homocysteine in IS patients. And this association is independent of other causative factors of an elevated level of homocysteine.
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