目的：分析睡眠呼吸暂停综合征（sleep apnea syndrome，SAS）合并卒中患者的血清炎性标志物和血管内皮功能指标的表达水平，并探讨与SAS发生卒中相关的危险因素。
方法：研究对象包括35例单纯SAS患者以及38例SAS合并卒中的患者。检测并比较2组患者血清内皮型一氧化氮合酶、丙二醛和肿瘤坏死因子α的表达水平。分析与SAS患者发生卒中相关的危险因素。
结果：SAS合并卒中患者的血清内皮型一氧化氮合酶、丙二醛和肿瘤坏死因子α水平均显著高于单纯SAS患者（P值均＝0.000）。单因素分析结果显示，性别（P＝0.012）、年龄（P＝0.009）、SAS病程（P＝0.000）和高血压病史（P＝0.000）均与SAS合并卒中相关；多因素分析结果显示，SAS病程[风险比为9.12（95%可信区间：2.15～13.88），P＝0.000]和高血压病史[风险比为5.05（95%可信区间：2.74～10.52），P＝0.000]是SAS合并卒中的独立影响因素。
结论：SAS合并卒中患者的血清炎性标志物和血管内皮功能指标的表达水平显著升高，提示内皮功能损害进一步加重。SAS病程＞1年和有高血压病史的SAS患者更易发生卒中。
Abstract
Objective: To investigate the expressions of serum inflammatory markers and markers for endothelial function in patients with sleep apnea syndrome (SAS) complicated with stroke, and explore the risk factors related to stroke onset in SAS patients.
Methods: This study included 35 patients with simple SAS and 38 SAS patients complicated with stroke. The expression levels of serum endothelial nitric oxide synthase, malondialdehyde (MDA) and tumor necrosis factor α (TNFα) were detected and compared between the simple SAS patients and the SAS patients complicated with stroke. The related factors of stroke onset in patients with SAS were examined.
Results: The expression levels of serum endothelial nitric oxide synthase, MDA and TNFα in SAS patients complicated with stroke were significantly higher than those in simple SAS patients (all P = 0.000). Univariate analysis showed that gender (P = 0.012), age (P = 0.009), the course of SAS (P = 0.000) and the history of hypertension (P = 0.000) were associated with stroke onset in SAS patients. Multivariate analysis showed that the course of SAS [hazard ratio: 9.12 (95% confidence interval: 2.15-13.88); P = 0.000] and the history of hypertension [hazard ratio: 5.05 (95% confidence interval: 2.74-10.52); P = 0.000] were the independent factors for stroke onset in SAS patients.
Conclusion: The expression levels of serum inflammatory markers and markers for endothelial function in SAS patients complicated with stroke are increased, indicating the further dysfunction of endothelial cells. The course of SAS more than one year and the history of hypertension are independent risk factors involved in the onset of stroke in SAS patients.
关键词
睡眠呼吸暂停综合征 /
卒中 /
炎性标志物 /
内皮功能 /
危险因素
Key words
Sleep apnea syndrome /
Stroke /
Inflammatory markers /
Endothelial function /
Risk factors
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