Sleep-disordered breathing among acute ischemic stroke patients in Brazil
Sleep-disordered breathing among acute ischemic stroke patients in Brazil
复制标题
DOI：
10.1016/j.sleep.2015.11.008
复制
发表时间：
2016-03-01
期刊：
影响因子：
4.8
通讯作者：
Pontes-Neto, Octavio M.
中科院分区：
文献类型：
--
作者：
Camilo, Millene R.;Schnitman, Saul V.;Pontes-Neto, Octavio M.
目的：睡眠呼吸障碍（SDB）在急性中风患者中非常常见，并且与不良预后相关。然而，在发展中国家，缺乏关于 SDB 与卒中之间关系的数据。该研究旨在描述巴西患者在缺血性中风急性期发生 SDB 的频率和严重程度；确定这些患者与 SDB 相关的临床和实验室数据；并评估中风六个月后睡眠呼吸暂停与功能结果之间的关系。方法：在入院时收集临床数据和实验室检查。多导睡眠图在中风症状出现后的第一晚进行。功能结果通过改良 Rankin 量表 (mRS) 进行评估。结果：我们对 69 名首次发生急性缺血性中风的患者进行了前瞻性评估。平均呼吸暂停低通气指数 (AHI) 为 37.7 +/- 30.2。 53 名患者 (76.8%) 表现出 AHI >= 10，主要表现为阻塞性呼吸事件 (90.6%)，33 名患者 (47.8%) 患有严重的睡眠呼吸暂停。年龄（OR：1.09；95% CI：1.03-1.15；p = 0.004）和血细胞比容（OR：1.18；95% CI：1.03-1.34；p = 0.01）是睡眠呼吸暂停的独立预测因素。年龄（OR：1.13；95% CI：1.03-1.24；p = 0.01）、体重指数（OR：1.54；95% CI：1.54-2.18；p = 0.01）和血细胞比容（OR：1.19；95% CI：1.01-1.40；p = 0.04）是独立预测因素严重的睡眠呼吸暂停。调整混杂因素后，美国国立卫生研究院卒中量表（NIHSS；OR：1.30；95% CI：1.1-1.5；p = 0.001）和严重睡眠呼吸暂停（OR：9.7；95% CI：1.3-73.8；p = 0.03）与 6 个月时 mRS > 2 独立相关。巴西的 SDB 频率很高。严重的睡眠呼吸暂停与该人群中风后长期功能结果不佳有关。 (C) 2015 Elsevier B.V. 保留所有权利。
Objectives: Sleep-disordered breathing (SDB) is very common in acute stroke patients and has been related to poor outcome. However, there is a lack of data about the association between SDB and stroke in developing countries. The study aims to characterize the frequency and severity of SDB in Brazilian patients during the acute phase of ischemic stroke; to identify clinical and laboratorial data related to SDB in those patients; and to assess the relationship between sleep apnea and functional outcome after six months of stroke.Methods: Clinical data and laboratorial tests were collected at hospital admission. The polysomnography was performed on the first night after stroke symptoms onset. Functional outcome was assessed by the modified Rankin Scale (mRS).Results: We prospectively evaluated 69 patients with their first-ever acute ischemic stroke. The mean apnea-hypopnea index (AHI) was 37.7 +/- 30.2. Fifty-three patients (76.8%) exhibited an AHI >= 10 with predominantly obstructive respiratory events (90.6%), and thirty-three (47.8%) had severe sleep apnea. Age (OR: 1.09; 95% CI: 1.03-1.15; p = 0.004) and hematocrit (OR: 1.18; 95% CI: 1.03-1.34; p = 0.01) were independent predictors of sleep apnea. Age (OR: 1.13; 95% CI: 1.03-1.24; p = 0.01), body mass index (OR: 1.54; 95% CI: 1.54-2.18; p = 0.01), and hematocrit (OR: 1.19; 95% CI: 1.01-1.40; p = 0.04) were independent predictors of severe sleep apnea. The National Institutes of Health Stroke Scale (NIHSS; OR: 1.30; 95% CI: 1.1-1.5; p = 0.001) and severe sleep apnea (OR: 9.7; 95% CI: 1.3-73.8; p = 0.03) were independently associated to mRS > 2 at six months, after adjusting for confounders.Conclusion: Patients with acute ischemic stroke in Brazil have a high frequency of SDB. Severe sleep apnea is associated with a poor long-term functional outcome following stroke in that population. (C) 2015 Elsevier B. V. All rights reserved.