阻塞性睡眠呼吸暂停对急性脑梗死患者 心脏结构和功能的影响

Effect of obstructive sleep apnea on cardiac structure and function in patients with acute cerebral infarction

摘要:

目的 探讨急性脑梗死患者阻塞性睡眠呼吸暂停（OSA）与心脏脏器损害的关系。方法 选取 2015 年3 月—2018 年3 月在安徽医科大学附属安庆医院就诊的113 例急性脑梗死患者作为研究对象。采用多 导睡眠仪评估患者OSA 发生率及严重程度；采用超声心动图评价患者左室质量指数、室间隔和左室后壁厚 度、左室射血分数及左心房增大。结果 70 例（61.9%）脑梗死患者患有OSA（呼吸紊乱指数≥ 5 次/h），其 中67.1% 为男性。与无OSA 患者比较，OSA 急性脑梗死患者左室质量指数、室间隔厚度、左室后壁厚度增加， 左心房增大（P <0.05）。有、无OSA 患者左室射血分数比较，差异无统计学意义（P >0.05），且均在正常范围内。 结论 急性脑梗死患者的OSA 发病率高，且OSA 与心脏靶器官损害存在关联。

Abstract:

Objective To explore the relationship between obstructive sleep apnea (OSA) and cardiac organ damage in patients with acute cerebral infarction. Methods A total of 113 patients with acute cerebral infarction were enrolled. Patients underwent full multichannel 24-h polysomnography for evaluation of OSA and echocardiography to evaluate left ventricle mass index, thickness of interventricular septum and posterior wall, left ventricle ejection fraction and left atrium enlargement. Results A total of 61.9% (70) of patients, mostly men (67.1%), with acute cerebral infarction had OSA (AHI ≥5). Patients with acute cerebral infarction and OSA showed a significant increase (P < 0.05) of left ventricle mass index, interventricular septum and posterior wall thickness and a significant left atrial enlargement as compared with patients without OSA. Left ventricle ejection fraction was not significantly different in acute cerebral infarction patients with and without OSA and was within normal limits. Conclusions This study confirms the high prevalence of OSA in acute cerebral infarction patients, suggesting an association between OSA and cardiac target organ damage.