摘要
目的探讨伴有阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的缺血性脑血管病患者(ischemic cerebrovascular disease,ICVD)血同型半胱氨酸(homocysteine,Hcy)水平。方法从南京脑卒中注册系统中筛选76例ICVD患者,行多导睡眠图(PSG)监测,并检测纤维蛋白原(FBG)、高密度脂蛋白胆固醇(HDL—C)、低密度脂蛋白胆固醇(LDL—C)、甘油三酯(TG)、血浆Hcy。结果76例患者中有57例存在呼吸暂停现象,其中53例(69.7%)诊断为OSAHS;排除4例中枢性呼吸暂停患者,将72例ICVD患者根据呼吸暂停加低通气指数(AHI)值分为4组:无呼吸暂停组19例,AHI值2.38±0.96,Hcy值(8.78±2.01)μmol/L;轻度OSAHS21例,AHI值14.14±4.37,Hcy值(12.91±3.00)μmol/L;中度OSAHS 24例,AHI值29.62±5.81,Hcy值(14.85±4.15)μmoL/L;重度OSAHS8例,AHI值46.75±2.82,Hcy值(19.30±4.82)μmol/L。4组间Hcy值差异有统计学意义(F=40.32,P〈0.01)。Hcy与AHI存在显著相关性(r=0.598,P〈0.01)。结论红ICVD患者中,OSAHS患病率较高,且以轻中度为主;Hcy在ICVD合并OSAHS患者时具有升高趋势,且随着阻塞程度的进展而加重。
Objective To investigate the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and plasma homocysteine (Hcy) levels in patients with ischemie cerehrovascular disease (ICVD). Methods Seventy-six patients with ICVD were monitored with polysomnography (PSG) for 7--8 hours during sleeping. The levels of fibrinogen ( FBG), high density lipoprotein cholesterol ( HDL- C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and plasma Hey were assessed. Results Of the 76 ICVD patients, 57 showed apnea symptom during sleeping, of which 53 (69. 7% ) were diagnosed with OSAHS and 4 with central sleep apnea. According to the mean apnea-hypopnea index (AHI) , the severity of apnea was classified as no apnea symptom (19 cases with mean AHI of 2. 38±0. 96 and Hcy level of (8. 78±2. 01 )μmol/L), mild apnea (21 cases with mean AHI of 14. 14 ±4.37 and Hcy level of (12. 91±3.00) μmoL/L), moderate apnea (24 eases with mean AHI of 29. 62±5.81 and Hey level of ( 14. 85±4. 15) μmol/L) and severe apnea (8 cases with mean AHI of 46. 75±2. 82 and Hey level of (19.30±4. 82)μmol/L). The level of Hey was statistical significant among these 4 groups (F = 40.32,P〈0.01) and correlated with the mean AHI(r =0.598,P〈0.01). Conclusion Patients with ICVD have a high morbidity of OSAHS, mainly suffering from mild to moderate apnea ; The plasma Hcy level elevates in the ICVD patients with OSAHS and is correlated with the severity of apnea.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2010年第6期408-411,共4页
Chinese Journal of Neurology
基金
南京市科技计划项目资助项习(200702066)