不同疾病严重程度脑梗死合并OSAS患者的血清皮质醇水平影响因素及与NIHSS评分和呼吸暂停低通气指数的相关性  

Influencing factors of serum cortisol level in patients with different severity of cerebral infarction and OSAS and its correlation with NIHSS score and apnea hypopnea index

作　　者：石霖 何青 侯志雷 朱慧芳[2] SHI Lin;HE Qing;HOU Zhi-lei;ZHU Hui-fang(Department of Rehabilitation Medicine,the Fifth Clinical College of Henan University of Chinese Medicine,Zhengzhou Peoples Hospital,Zhengzhou 450000,China;Department of Neurology,the Fifth Clinical College of Henan University of Chinese Medicine,Zhengzhou Peoples Hospital,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床学院,郑州人民医院康复医学科,郑州450000 [2]河南中医药大学第五临床学院,郑州人民医院康复医学科神经内科,郑州450000

出　　处：《医药论坛杂志》2025年第5期505-509,共5页Journal of Medical Forum

摘　　要：目的探究不同疾病严重程度脑梗死(cerebral infarction,CI)合并阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者的皮质醇(cortisol,Cor)水平影响因素以及Cor与美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分和呼吸暂停低通气指数(apnea hypopnea index,AHI)的相关性。方法从郑州人民医院神经内科2020年1月至2021年7月期间住院并且完成多导睡眠监测(polysomnography,PSG)的脑梗死患者中选取175例作为研究纳入对象。根据AHI分为脑梗死组(AHI<5)、脑梗死合并OSAS组(AHI≥5)。脑梗死合并OSAS组根据NHISS评分分为NHISS<10分组、NHISS≥10分组,脑梗死合并OSAS组根据AHI分为轻中度组(5/h≤AHI<30/h)、重度组(AHI≥30/h),记录175例脑梗死患者的基线资料、生化指标、血清皮质醇水平、睡眠参数、清晨血压等检测数据,分析脑梗死合并OSAS患者血清皮质醇水平的主要影响因素。分析Cor与NIHSS评分和AHI的相关性。结果相比于脑梗死组,脑梗死合并组患者的打鼾比例、收缩压、舒张压、C反应蛋白以及BMI明显升高(P<0.05);脑梗死合并OSAS组患者在呼吸暂停最长时间以及夜间最低血氧饱和度上的Cor水平明显升高(P<0.05);脑梗死合并OSAS患者Cor水平的独立影响因素是AHI、NHISS、呼吸暂停最长时间、夜间最低血氧饱和度;Cor水平与AHI、NHISS均呈正相关。结论脑梗死患者发生OSAS后会影响炎性介质水平、血流动力学,随着脑梗死合并OSAS患者AHI、NHISS的水平增加会刺激机体皮质醇的分泌。Objective To explore the influencing factors of cortisol(Cor)levels in patients with different severity of cere-bral infarction(CI)combined obstructive sleep apnea syndrome(OSAS)and the correlation between Cor and national in-stitutes of health stroke scale national institutes of health stroke scale(NIHSS)score and apnea hypopnea index(AHI).Methods Totally 175 patients with cerebral infarction who were hospitalized from January 2020 to July 2021 in the De-partment of Neurology of Zhengzhou Peoples Hospital and completed polysomnography(PSG)were selected as the study subjects.According to AHI,they were divided into cerebral infarction group(AHI<5)and cerebral infarction combined with OSAS group(AHI≥5).The cerebral infarction combined with OSAS group was divided into NHISS<10 score group and NHISS≥10 score group according to the NHISS score,and the cerebral infarction combined with OSAS group was divided into mild-moderate group(5/h≤AHI<30/h)and severe group(AHI≥10)according to (AHI 30/h),record baseline data,biochemical indicators,serum cortisol levels,sleep parameters,morning blood pressure and other test data of 175 patients with cerebral infarction,and the main influencing factors of serum cortisol levels in patients with cerebral infarction and OSAS were analyzed.The correlation between Cor and NIHSS score and AHI was analyzed.Results Compared with cerebral infarction group,the proportion of snoring,systolic blood pressure,diastolic blood pressure,C-reactive protein and BMI of cerebral infarction group significantly increased(P<0.05).Cor level on the longest duration of apnea and the lowest nocturnal oxygen saturation'significantly increased in patients with cerebral infarction combined with OSAS group(P<0.05).The independent influencing factors of Cor level in patients with cerebral infarction complicated with OSAS were AHI,NHISS,longest duration of apnea and lowest nocturnal oxygen saturation.Cor levels were positively correlated with AHI and NHISS.Conclusion The occurrence of OSAS in patients with c

关 键 词：脑梗死 阻塞性睡眠呼吸暂停综合征 皮质醇 影响因素 美国国立卫生研究院卒中量表 呼吸暂停低通气指数 相关性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]