Relationship Between Obstructive Sleep Apnea Hypopnea Syndrome And Cerebrovascular Disease

Part Ⅰ Analysis of prevalence and risk factors of low sleep quality in target population of stroke screeningObjective:To compare the detection rate of low sleep quality in stroke patients with different target populations.Methods:A cross-sectional study was conducted to collect 4,716 cases of stroke screening in 2016,including those aged≥40 years and completing the Pittsburgh score,excluding patients with severe systemic diseases,malignant tumors,etc,which significantly affected quality of life and life expectancy.The PSQI score>7 is divided into low sleep quality.Theχ² test was used to analyze the difference in the detection rate of low sleep quality among the groups.Logistic regression analysis was used for risk factors associated with low quality sleep.Results:Among the 4,716 respondents,the incidence of low sleep quality was 7.9%.The incidence of low sleep quality was considered significantly in different age groups,different genders,and different stroke risk ratings（P<0.05）.There was no statistical difference between the different levels of education and the lack of exercise.Using low sleep quality as a dependent variable,Logistic regression analysis was performed on factors that may affect low sleep quality.It was found that age,women,marital status,retirement,mass drinking,vegetarian diet,and increased risk rating of stroke were associated with low sleep quality.Summary:There is a low quality of sleep in the target population of stroke screening.Age,gender,and stroke risk ratings are all factors associated with low sleep quality.Among them,age,female,widowhood,retirement,heavy drinking,vegetarian diet,and increased risk rating of stroke are risk factors for low sleep quality.Part Ⅱ Relationship between obstructive sleep apnea hypopnea syndrome and acute cerebral infarctionObjective:To study the relationship between OSAHS and acute cerebral infarction.Methods:Patients who had undergone head nucleus magnetic examina-tion and sleep portable monitoring（PM）from January 2017 to December 2017were reviewed.If the patients had sleep apnea events,obstructive sleep apnea was selected.According to the apnea hypopnea index（AHI）and the results of the patient’s head nuclear magnetic examination,the patients were divided into45 patients with OSAHS alone,27 patients with OSAHS combined with cerebral infarction,14 patients with non-OSAHS non-cerebral infarction,and5 patients with simple cerebral infarction.Statistical analysis was performed using methods such as chi-square test and rank sum test.Results:1.A total of 91 patients were collected.This study found that the incidence of cerebral infarction in OSAHS patients was higher than that in non-OSAHS patients.2.There was a statistically significant gender difference between OSAHS combined with cerebral infarction group and OSAHS alone group.3.The difference of AHI and LSaO₂ between OSAHS combined with cerebral infarction group and simple cerebral infarction group was statistical significantly.The AHI of OSAHS combined with cerebral infarction group patients was significantly higher than that of patients with simple cerebral infarction,while the LSaO₂ of OSAHS combined with cerebral infarction group patients was significantly lower than that of simple cerebral infarction simple patients.4.The incidence of cerebral infarction in patients of OSAHS combined with cerebral infarction group was higher than that in patients of simple cerebral infarction group.The incidence of posterior circulation infarction was significantly higher in the OSAHS combined with cerebral infarction group（63.6%）than the incidence in the simple cerebral infarction group（36.4%）.5.There was no statistically significant difference in blood indexes between the OSAHS combined with cerebral infarction group and the simple cerebral infarction group（P>0.05）.Summary:OSAHS patients may have a higher incidence of cerebral infarction,and males are one of the risk factors for the occurrence of cerebral infarction in OSAHS patients,and the location of cerebral infarction is also associated with OSAHS,while the mechanism of cerebral infarction caused by OSAHS may have nothing to do with blood lipid,homocysteine,inflammation and other indicators.Part Ⅲ The analysis of susceptibility weighted imaging in patients with obstructive sleep apnea hypopnea syndromeObjective:To study the relationship between obstructive sleep apnea hypopnea syndrome（OSAHS）and cerebral microbleeds.Methods:Collected the patients from the Department of Neurology in our hospital from January 2018 to December 2018,confirmed diagnosis with OSAHS.Investigating the general conditions（age,gender,etc.）and clinical manifestations（unclear speech,limb weakness,etc.）,collecting laboratory tests（blood routine,blood biochemistry,etc.）,imaging and other examinations（head nuclear,etc.）,and sleep monitoring data.Results:A total of 8 cases were collected in this study,all male.Among them,1 case was mild OSAHS,3 cases were moderate OSAHS,and 4 cases were severe OSAHS.In 7 cases,SWI showed no obvious abnormalities in brain parenchyma.1 case of SWI examination showed multiple cerebral microbleeds in the bilateral frontal lobes,pons,bilateral thalamus and basal ganglia.Summary:This study did not find a correlation between obstructive sleep apnea hypopnea syndrome and cerebral microbleeds.Conclusion:1.Increased age,female,widowed,retired,heavy drinking,vegetarian diet,and increased risk rating of stroke among target populations for stroke screening are risk factors for low sleep quality.2.OSAHS patients may have a higher incidence of cerebral infarction,male is a risk factor for cerebral infarction in OSAHS patients,and OSAHS patients are prone to posterior circulation infarction.3.This study did not find a correlation between obstructive sleep apnea hypopnea syndrome and cerebral microbleeds.