阻塞性睡眠呼吸暂停综合征患者颅内外动脉粥样硬化病变的超声检测  

Ultrasonographic characteristics of intracranial and extracranial atherosclerosis lesion in patients with obstructive sleep apnea syndromes

作　　者：李娜[1] 刘玉梅[1] 赵颖[2] 王力力[1] 侯伟红[1] 赵越[1] 华扬[1] Li Na;Liu Yumei;Zhao Ying;Wang Lili;Hou Weihong;Zhao Yue;Hua Yang(Department of Vascular Ultrasonography,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Stomatology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管超声诊断科,北京100053 [2]首都医科大学宣武医院口腔科,北京100053

出　　处：《中华超声影像学杂志》2020年第8期657-661,共5页Chinese Journal of Ultrasonography

摘　　要：目的:通过超声对阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndromes,OSAS)患者颅内外动脉病变的联合筛查,评估不同程度OSAS患者颅内外动脉粥样硬化病变的分布情况。方法:连续性纳入2016年7月至2019年7月在首都医科大学宣武医院神经内科与呼吸科联合确诊为OSAS的患者139例,根据OSAS程度分为轻度组(53例)、中度组(35例)和重度组(51例)。比较三组间脑血管病的危险因素,颅内外动脉粥样硬化病变程度、分布,以及缺血性脑卒中发生率的差异性。结果:①139例OSAS患者中男性(64.7%)多于女性(35.3%);在脑血管病的危险因素中,高血压病检出率最高(50.4%),其次为高脂血症(48.9%);重度OSAS组体质指数(BMI)、高血压病与缺血性脑卒中患病率高于轻度组(均P<0.017)。②颅外动脉粥样硬化病变总检出率(83.5%)明显高于颅内动脉粥样硬化病变总检出率(23.0%)(P<0.01)。③颅外动脉粥样硬化病变以单纯斑块形成检出率最高(51.1%,71/139例),三组间颅外动脉粥样硬化病变率差异无统计学意义(P=0.106);随着OSAS程度的加重,颅外动脉狭窄程度有增加趋势(P=0.006);OSAS病变程度与颅外动脉狭窄程度间存在弱相关性(r s=0.263,P=0.002)。④颅内动脉受累血管以大脑中动脉较多见,占15.8%(22/139例),三组间颅内动脉病变率、病变程度及分布差异无统计学意义(均P>0.05)。结论:OSAS患者颅外动脉病变检出率较高,随着OSAS程度加重,颅外动脉粥样硬化狭窄病变程度及缺血性脑卒中的发生率有增加趋势。Objective To investigate the distribution characteristics of atherosclerosis in patients with obstructive sleep apnea syndromes(OSAS)by ultrasonography and explore the differences of intracranial and extracranial atherosclerosis lesions.Methods From July 2016 to July 2019,139 patients with OSAS confirmed by the department of neurology and/or respiratory of Xuanwu Hospital,Capital Medical University were enrolled retrospectively.According to the results of polysomnography(PSG),patients were divided into 3 groups:mild degree(53 cases),moderate degree(35 cases)and severe degree(51 cases).Demographic parameters,distribution and the severity of atherosclerosis both in intracranial and extracranial arteries,and the incidence of ischemic stroke were compared among the three groups.Results①Among 139 OSAS patients,there were more males(64.7%)than females(35.3%).Of all the risk factors for cerebrovascular diseases,the prevalence of hypertensin was the highest(50.4%),followed by hyperlipidemia(48.9%).The prevalences of hypertension and ischemic stroke,the body mass index(BMI)in severe OSAS group were higher than those in mild group(all P<0.017).②The total detection rate of extracranial atherosclerosis(83.5%)was significantly higher than that of intracranial atherosclerosis(23.0%)(P<0.01).③The extracranial atherosclerotic lesion with highest detection rate of was simple plaque formation(51.1%,71/139 cases),and there was no significant difference in extracranial lesions among the three groups(P=0.106).However,with the aggravation of OSAS degree,the stenosis degree of extracranial artery increased(P=0.006),and there was a weak correlation between the severity of OSAS and the degree of extracranial artery stenosis(rs=0.263,P=0.002).④The incidence of middle cerebral artery stenosis accounted for 15.8%(22/139 cases)of intracranial arteries involved and there were no significant differences in the rate,degree and distribution of intracranial artery lesions among the three groups(all P>0.05).Conclusions The detection rate o

关 键 词：超声检查 阻塞性睡眠呼吸暂停综合征 动脉粥样硬化 卒中 

分 类 号：R766[医药卫生—耳鼻咽喉科] R543.5[医药卫生—临床医学]