摘要
目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及血压变异性与脑小血管病(CSVD)影像学总负荷的相关性。方法纳入2022年12月至2023年12月开封市中心医院收治的152例CSVD患者作为研究对象,CSVD患者根据有无OSAHS分为OSAHS组和无OSAHS组,比较两组CSVD影像学总负荷与血压变异性;将OSAHS患者根据严重程度分为轻度、中度和重度,比较不同严重程度OSAHS患者CSVD影像学总负荷与血压变异性。按照脑小血管影像学总负荷分为0~2分组和3~4分组,比较两组多导睡眠监测(PSG)相关指标,采用Spearman相关性分析CSVD患者影像学总负荷与PSG相关指标的相关性。结果OSAHS患者CSVD影像学总负荷评分、收缩压血压变异性、呼吸暂停低通气指数(AHI)、血氧饱和度(SaO_(2))<90%比例明显高于无OSAHS患者,夜间最低血氧饱和度(Min SaO_(2))明显低于无OSAHS患者(P<0.05),两组舒张压血压变异性、睡眠效率比较差异无统计学意义(P>0.05);中、重度亚组CSVD影像学总负荷评分明显高于轻度亚组(P<0.05),中、重度OSAHS患者CSVD影像学总负荷评分比较差异无统计学意义(P>0.05),收缩压血压变异性和舒张压血压变异性比较差异有统计学意义(P<0.05),轻中度者收缩压血压变异性明显低于重度者,中度者舒张压血压变异性明显低于重度者(P<0.05);MRI总负荷分组0~2分组和3~4分组收缩压血压变异性比较差异无统计学意义(P>0.05),MRI总负荷分组3~4分组AHI、SaO_(2)<90%比例高于1~2分组,差异有统计学意义(P<0.05);0~2分组Min SaO_(2)、睡眠效率、舒张压血压变异性明显高于3~4分组(P<0.05);两组间睡眠效率比较差异无统计学意义(P>0.05);CSVD患者影像学总负荷与Min SaO_(2)、睡眠效率、舒张压血压变异性呈负相关(P<0.05)。结论合并OSAHS的CSVD患者CSVD影像学总负荷、血压变异性升高,并且不同严重程度OSAHS患者CSVD影像学总负荷、血压变异性有明显差异,重度者较高,OSAHS与CSVD患者影像学总负荷相关,低氧程度越严重,睡眠效率越差,舒张压血压变异性越低,影像学总负荷越重。
Objective To analyze the correlation among obstructive sleep apnea hypopnea syndrome(OSAHS),blood pressure variability and total imaging burden of cerebral small vascular diseases(CSVD).Methods A total of 152 CSVD patients admitted to KaiFeng Central Hospital from December 2022 to December 2023 were included and separated into OSAHS group and non-OSAHS group according to the occurrence of OSAHS.The total imaging burden and blood pressure variability of the two groups were compared.OSAHS patients were classified into mild,moderate and severe patients according to their severity,and the total imaging burden and blood pressure variability of CSVD with different severity of OSAHS were compared.According to the total imaging load of small cerebral vessels,the patients were divided into 0-2 group and 3-4 group,and polysomnography(PSG)related indicators were compared between the two groups,and the correlation between total imaging load and PSG related indicators was analyzed by Spearman correlation.Results The total imaging load score,the variability of systolic and diastolic blood pressure,apnea hypopnea index(AHI)and blood oxygen saturation(SaO_(2))<90%in OSAHS group were significantly higher than that in non-OSAHS(P<0.05),while minimum blood oxygen saturation at night(Min SaO_(2))was lower(P<0.05).There was no statistically significant difference in the variability of diastolic blood pressure and sleep efficiency between the two groups(P>0.05).The total imaging load score of CSVD in moderate and severe subgroup was significantly higher than that in mild subgroup,and the difference in total imaging load score of CSVD in moderate and severe OSAHS patients was not statistically significant(P>0.05).The comparison of variability of systolic and diastolic blood pressure had statistically significant difference(P<0.05).The variability of systolic blood pressure in mild and moderate patients was significantly lower than that in severe patients,and the variability of diastolic blood pressure in moderate patients was significantly lower than that in severe patients(P<0.05).There was no statistically significant difference in systolic blood pressure variability between the 0-2 group and the 3-4 group in total MRI load group(P>0.05),while the proportion of AHI,SaO_(2)<90%ratio in 3-4 group was higher than that in 0-2 group(P>0.05),with statistically significant difference(P<0.05).Min SaO_(2),sleep efficiency and diastolic blood pressure variability in 0-2 group were significantly higher than those in 3-4 group(P<0.05).There was no statistically significant difference in sleep efficiency between the two groups(P>0.05).The total imaging load of CSVD was negatively correlated with Min SaO_(2),sleep efficiency,the variability of diastolic blood pressure(P<0.05).Conclusion The total imaging load and blood pressure variability increases in patients with CSVD complicated with OSAHS,and total imaging load and the blood pressure variability of CSVD patients with OSAHS of different severity are significantly different,and the severe patients are higher.OSAHS is correlated with total imaging load in CSVD patients.The more severe the degree of hypoxia,the worse the sleep efficiency,and the lower the variability of diastolic blood pressure,the heavier the total imaging load.
作者
王婷
刘美香
史兆博
马丽丽
Wang Ting;Liu Meixiang;Shi Zhaobo;Ma Lili(Xinxiang Medical College,Henan 453000,China)
出处
《脑与神经疾病杂志》
2025年第8期497-501,共5页
Journal of Brain and Nervous Diseases
基金
开封市科技攻关项目(1703035)。
关键词
脑小血管病
总负荷
血压变异性
阻塞性睡眠呼吸暂停低通气综合征
Cerebral small vascular disease
Total burden
Blood pressure variability
Obstructive sleep apnea hypopnea syndrome
