阻塞性睡眠呼吸暂停与脑小血管病影像学特征之间的相关性研究OA

Objective To systematically evaluate the association between obstructive sleep apnea(OSA)and the radiological features of cerebral small vessel disease(CSVD),to investigate the potential mechanism of OSA in the develop-ment and progression of cerebrovascular diseases,and to provide a new scientific basis for optimizing clinical management strat-egies.Methods The patients with first-episode ischemic stroke and CSVD who were admitted from May 2021 to October 2023 were enrolled according to the inclusion and exclusion criteria.Cranial MRI was performed to evaluate the radiological features of CSVD,and sleep respiration testing was conducted to calculate hypoxic burden(HB),a specific indicator for OSA,which was compared with traditional indicators.The multivariate logistic regression analysis was used to investigate the association be-tween these hypoxic indicators and CSVD,and the receiver operating characteristic(ROC)curve was plotted to compare the correlation between hypoxic indicators and outcome measures.Results A total of 243 patients with first-episode acute isch-emic stroke were enrolled in this study,among whom there were 155 male patients(63.8%)and 88 female patients.The multi-variate logistic regression analysis showed that both HB OR=1.037,95%CI 1.020-1.055,P<0.001)and apnea-hypopnea in-dex(AHI)(OR=1.044,95%CI 1.020-1.070,P<0.001)were significantly positively correlated with white matter hyperin-tensities(WMH).The ROC curve analysis showed that the correlation between HB and WMH(AUC=0.722)was better than that between HB and AHI(AUC=0.670).However,sleep time with oxygen saturation below 90%and oxygen desaturation in-dex were not associated with WMH.OSA was not associated with enlarged perivascular spaces,cerebral microbleeds,or lacu-nar infarction.Conclusion Compared with traditional indicators,HB has a stronger correlation with WMH and can be used as a more effective indicator for risk assessment in OSA patients,thereby providing a precise basis for individualized intervention.