阻塞性睡眠呼吸暂停低通气综合征与青年脑出血患者早期血肿扩大的关系及对预后的影响  

Relationship between obstructive sleep apnea hypopnea syndrome and early hematoma enlargement in young patients with cerebral hemorrhage and its influence on prognosis

作　　者：任梦杨 张爱玲 丁娜 REN Meng-yang;ZHANG Ai-ling;DING Na(Department of Neurology,The Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院神经内科,郑州450003

出　　处：《医药论坛杂志》2025年第1期12-16,共5页Journal of Medical Forum

摘　　要：目的探究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与青年脑出血患者早期血肿扩大的关系及对预后的影响。方法选取2020年9月至2022年9月在郑州人民医院神经内科诊治的青年脑出血合并颅内血肿患者127例,其中合并OSAHS的脑出血患者58例为试验组,无OSAHS的脑出血患者69例为对照组。CT检查计算和记录患者入院时血肿量(V1)和入院后24 h复查时血肿量(V2)。结果与对照组相比,试验组V2/V1比值相对较大[(1.02±0.28)与(1.24±0.57),P<0.05]。根据OSAHS严重程度分组后,与对照组相比,轻度、中度和重度OSAHS组的V2/V1比值显著较大(P<0.05);重度OSAHS组的V2/V1比值显著高于轻度和中度OSAHS组(P均<0.05)。患者出院时,对照组与试验组患者在NIHSS评分上无显著差异[(8.09±2.32)与(8.14±2.43),P>0.05];但发病3周后试验组预后不良的患者比例显著较高(40.6%与74.1%,P<0.001),预后较差。结论OSAHS可显著促进脑出血合并颅内血肿青年患者的血肿扩大,OSAHS严重程度越大,血肿扩大程度越大,并且与较差预后相关。Objective To investigate the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)and early hematoma enlargement in young patients with cerebral hemorrhage and its impact on prognosis.Methods A total of 127 young patients with cerebral hemorrhage and intracranial hematoma were enrolled in the Zhengzhou People's Hospital from September 2020 to September 2022.Based on the OSAHS complication,the patients were divided into cerebral hemorrhage combined with OSAHS group(experimental group,n=58)and cerebral hemorrhage without OSAHS(control group,n=69).CT examination were used to calculate and record the hematoma volume at admission(V1)and re-examination 24 hours after admission(V2).Results Compared with the control group,the V2/V1 ratio[(1.02±0.28)vs(1.24±0.57),P<0.05]were significantly higher in the experimental group.Compared with the control group,the V2/V1 ratio were significantly higher in the mild,moderate and severe OSAHS groups(P<0.05).The ratio of V2 and V2/V1 in the severe OSAHS group were significantly higher than that in the mild and moderate OSAHS group(P<0.05).Compared with the control group,the proportion of patients with poor prognosis in the experimental group 3 weeks after onset was significantly higher(40.6%vs 74.1%,P<0.001).Conclusion OSAHS can significantly promote hematoma expansion in young patients with cerebral hemorrhage and intracranial hematoma,and the greater the severity of OSAHS,the greater the degree of hematoma enlargement,and it is associated with a poor prognosis.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 脑出血 颅内血肿 青年 血肿扩大 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]