论文部分内容阅读
目的观察椎基底动脉缺血发作与睡眠呼吸暂停低通气综合征(SAHS)之间的关系,以及椎动脉内支架植入治疗对 SAHS 的作用。方法对20例椎动脉血管内支架成形术患者在治疗前后进行多导睡眠图监测,同时记录患者的一般资料和临床表现,填写 Epworth 嗜睡程度量表。按照成人 SAHS 的诊断标准进行诊断、分型,判断其严重程度及缺氧变化。治疗前后的比较采用配对 t 检验和秩和检验,偏态分布的计量资料以中位数和四分位间距表示。结果 20例椎基底动脉缺血性狭窄患者合并 SAHS 者17例,其中轻度10例、中度3例、重度4例,临床类型符合阻塞性睡眠呼吸暂停低通气综合征(OSAHS)。治疗后患者的呼吸暂停低通气指数[5.0(1.6～12.7)次/h]、最长呼吸暂停时间[(19.5±12.4)s]、呼吸暂停低通气时间占总睡眠时间百分比[2.3(0.6～9.8)%]、每小时动脉血氧饱和度下降4%的次数[5.8(2.7～17.0)次/h]明显低于治疗前[11.3(6.3～23.6)次/h、(31.5±18.6)s、6.9(2.6～14.3)%、10.1(5.3～29.0)次/h],治疗后患者的夜间最低动脉血氧饱和度[(86.1±3.3)%]明显高于治疗前[(83.6±7.1)%]。结论椎基底动脉缺血患者的睡眠结构紊乱,睡眠效率降低。患者具有较高的 SAHS 患病率,主要造成阻塞性睡眠呼吸暂停。椎动脉血管内支架成形术治疗可改善缺血性脑血管病患者的睡眠呼吸紊乱及缺氧状况。
Objective To observe the relationship between vertebrobasilar ischemia and sleep apnea-hypopnea syndrome (SAHS) and the effect of intra-vertebral artery stenting on SAHS. Methods 20 patients with vertebral artery stenting underwent polysomnography before and after treatment. The general information and clinical manifestations of the patients were recorded. The Epworth Sleepiness Scale was completed. According to the diagnosis of adult SAHS diagnostic criteria, type, to determine the severity and hypoxic changes. Before and after treatment using paired t test and rank sum test, skewed distribution of measurement data to the median and quartile spacing expressed. Results Twenty patients with vertebrobasilar ischemic stenosis had SAHS in 17 cases, of which 10 were mild, 3 moderate, and 4 severe. The clinical type was obstructive sleep apnea-hypopnea syndrome (OSAHS). The apnea hypopnea index (5.0 (1.6 ~ 12.7) times / h), the longest apnea time (19.5 ± 12.4 s), the apnea hypopnea time (% 9.8)%], and the number of arterial oxygen saturation decreased by 4% (5.8 (2.7-17.0) times / h] per hour was significantly lower than that of before treatment [11.3 (6.3-23.6) / h, (31.5 ± 18.6) (86.1 ± 3.3)%] after treatment was significantly higher than that before treatment [(83.6 ± 7.1)%, 6.9 (2.6-14.3)%, 10.1 %]. Conclusions Patients with vertebrobasilar ischemia have disturbed sleep structure and reduced sleep efficiency. Patients have a high prevalence of SAHS, mainly resulting in obstructive sleep apnea. Vertebral artery stenting can improve sleep-disordered breathing and hypoxia in patients with ischemic cerebrovascular disease.