The Effect Of OSAHS On Cerebral Artery Atherosclerosis

Objective:To investigate the effect of obstrustive sleep apnea-hypopnea syndrome (OSAHS) on cerebral atherosclerosis.Methods: Large-artery atherothrombotic stroke patients were chose according to TOAST typing. The pathological changes of intracalvarium and extracalvarium arteries were evaluated through brain magnetic resonance angiography (MRA),transcranial Doppler (TCD) and carotid artery cartic color Doppler ultrasound examination. Patients were divided into no stenosis group,stenosis <50% group,≥50% stenosis group according to the degree of artery stenosis. All patients received polysomnographic examination (PSG) and were divided into normal group: AHI <5 times / hour; mild OSAHS: 5 times -15 times / hour; moderate OSAHS 15 -30 times / hour; severe OSAHS: AHI≥30 times / hour according to sleep apnea-hypopnea index (AHI) . The difference of the degree ,number and distribution of cerebral artery stenosis between non-OSAHS group and OSAHS group was compared.Results:76 subjects were enrolled ultimately, including 19 subjects of non-OSAHS 32 patients with mild OSAHS and 25 patients with moderate to severe OSAHS. The intracranial artery stenosis in the non-OSAHS group was 21.1%(4/19), stenosis <50% was 15.8%,≥50% stenosis was 5.3%, multivessel stensis was 15.8%; In OSAHS group ,intracranial artery stenosis was 80.7%(46/57), in which stenosis<50% was 33.3%(19/57),≥50% was 47.4%(27/57),multivessel stenosis was 42.1%. In moderate to severe OSAHS group, patients with intracranial artery stenosis≥50% accounted for 72.0% and multivessel stenosis accounted for 60.0%. In mild OSAHS group, patients with intracranial artery stenosis≥50% accounted for 28.1% and multivessel stenosis accounted for 28.1%. 66 patients received carotid ultrasonography examination, 20.0% of subjects (3 / 15) in non-OSAHS group were diagnosed with carotid atherosclerosis, 28/51 patients (54.9%) in OSAHS group were diagnosed with carotid atherosclerosis, of which 11 patients(40.7%) in mild OSAHS group and 17 patients with bilateral carotid artery lesions as high as 41.7% in moderate-severe OSAHS group. There was no significant difference among 3 groups on the distribution of cerebral artery stenosis(P=0.588).Conclusions:OSAHS may be an important risk factor of cerebral atherosclerosis. The more severe OSAHS is, the more severe and widely cerebral atherosclerosis is. Interventions on OSAHS may reduce, delay or reverse the outcome of atherosc lerosis.