轻度缺血性脑卒中患者阻塞性睡眠呼吸暂停和认知障碍影响因素分析OA
Analysis of influencing factors of obstructive sleep apnea and cognitive impairment in patients with mild ischemic stroke
目的 探讨轻度缺血性脑卒中(IS)患者阻塞性睡眠呼吸暂停(OSA)和认知障碍(CI)影响因素,分析影响因素间的关系.方法 筛选2022 年3 月至2025 年3 月上海健康医学院附属周浦医院神经内科收治的轻度IS患者188 例,收集其临床资料.患者入院2d后,先后采用多导睡眠图(PSG)和蒙特利尔认知评估量表评价OSA和CI.根据是否发生OSA将患者首次分组,基于一般临床资料对其行多因素Logistic回归分析导致OSA发生的独立危险因素.根据是否发生CI将患者再次分组,基于一般临床资料和PSG资料对其行多因素Logistic回归分析导致CI的独立危险因素.汇总独立危险因素,分析各因素间的关系.结果 患者年龄为43～70 岁,平均(56.42±9.03)岁,男女比例为132∶56,OSA和CI发生率分别为62.77%和57.45%.多因素Logistic回归分析结果显示,男性(OR=3.112,95%CI:1.274～11.764)、高血压(OR=4.623,95%CI:1.543～14.684)、吸烟(OR=9.207,95%CI:2.343～35.831)是导致OSA发生的独立危险因素(均P＜0.05);男性(OR=2.875,95%CI:1.245～7.904)、高血压(OR=3.387,95%CI:1.337～11.425)、高呼吸暂停低通气指数(OR=7.257,95%CI:2.784～29.784)、低最低血氧饱和度(OR=4.627,95%CI:1.578～17.895)是导致CI发生的独立危险因素(均P＜0.05).导致两种疾病发生的独立危险因素间存在共性,其中低最低血氧饱和度的OSA患者CI发生风险较高.结论 轻度IS患者OSA和CI共同的影响因素为男性和高血压,且低最低血氧饱和度的OSA患者CI发生风险更高.
Objective To explore the influencing factors of obstructive sleep apnea(OSA)and cognitive impairment(CI)in patients with mild ischemic stroke(IS),and to analyze the relationship between the influencing factors.Methods A total of 188 patients with mild IS in Zhoupu Affiliated Hospital of Shanghai Health Medical University from March 2022 to March 2025 were selected,and their clinical data were collected.Two days after admission,OSA and CI of the patients were evaluated by using polysomnography(PSG)and Montreal cognitive assessment,respectively.The patients were initially grouped based on whether OSA occurred,and multivariable Logistic regression analysis was performed on their general clinical data to identify the independent risk factors for the occurrence of OSA.The patients were then grouped again based on whether CI occurred,and multivariable Logistic regression analysis was performed on their general clinical data and PSG data to identify the independent risk factors for the occurrence of CI.The independent risk factors were summarized,and their relationship was analyzed.Results The patients'age ranged from 43 to 70 years,with an average of(56.42±9.03)years.The male-to-female ratio was 132∶56.The incidence rates of OSA and CI were 62.77%and 57.45%,respectively.Multivariate Logistic regression analysis results showed that male(OR=3.112,95%CI:1.274-11.764),hypertension(OR=4.623,95%CI:1.543-14.684),and smoking(OR=9.207,95%CI:2.343-35.831)were the independent risk factors for the occurrence of OSA(all P＜0.05).Male(OR=2.875,95%CI:1.245-7.904),hypertension(OR=3.387,95%CI:1.337-11.425),high apnea-hypopnea index(OR=7.257,95%CI:2.784-29.784),and low minimum oxygen saturation(OR=4.627,95%CI:1.578-17.895)were the independent risk factors for the occurrence of CI(all P＜0.05).There were commonalities between the independent risk factors for the occurrence of these two diseases.The OSA patients with low minimum oxygen saturation had a higher risk of CI.Conclusion The common influencing factors for OSA and CI in patients with mild IS are male and hypertension,and OSA patients with low minimum oxygen saturation have a higher risk of CI occurrence.
张燕;张蔚;罗峥;李晋峰;金磊
201318 上海健康医学院附属周浦医院神经内科201318 上海健康医学院附属周浦医院神经内科201318 上海健康医学院附属周浦医院神经内科201318 上海健康医学院附属周浦医院神经内科201318 上海健康医学院附属周浦医院神经内科
缺血性脑卒中阻塞性睡眠呼吸暂停认知障碍影响因素
ischemic strokeobstructive sleep apneacognitive impairmentinfluencing factor
《临床神经病学杂志》 2026 (2)
90-95,6
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