Discussion About The Relationship Of Obstructive Sleep Apnea-hypopnea Syndrome With The Recurrence Of Non-cardiac Ischemic Stroke

Objective：To explore the relationship of the recurrence of non-cardiac ischemicstroke with the severity of obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods： In our prospective observational study, we consecutive enrolled227patients hospitalized in the Department of Neurology, Beijing Haidian hospital fromMarch,2008to July,2011. Recording the Baseline clinical datas and the results ofthe polysomnography of each people. According to apnea hypopnea index, thesepatients were divided into four groups: pure non-cardiac ischemic strokegroup(groupⅠ,n=52), non-cardiac ischemic stroke combined with mild OSAHSgroup(groupⅡ,n=60), non-cardiac ischemic stroke combined with moderate OSAHSgroup(groupⅢ,n=59), and non-cardiac ischemic stroke combined with severeOSAHS group(groupⅣ,n=56). Then we collected the baseline information, recordedother related risk factors （like hypertension, smoking history etc.）, and kept theresults of polysomnography. The patients were followed up by telephone orOutpatient department after12months. The amounts of non-cardiac ischemic strokerecurrence events and the influencing factors were compared with the results takenpreviously among different groups using logistic regression analysis.Results： The recurrence rates of pure non-cardiac ischemic stroke group,non-cardiac ischemic stroke combined with mild OSAHS group, non-cardiacischemic stroke combined with moderate OSAHS group, non-cardiac ischemicstroke combined with severe OSAHS group after one year were3.8%，5.0%，11.9%，and16.1%, respectively. The statistics results show that the number of non-cardiacischemic stroke combined with severe OSAHS group’s ischemic stroke recurrenceevents is with significant difference comparing to both pure non-cardiac ischemicstroke group and non-cardiac ischemic stroke combined with mild OSAHS group(P=0.033，0.046). While there is no significant difference observed among the othergroups(P=0.768,1.177,0.490,0.123). According to the logistic regression analysis, itshows that BMI(OR3.126，95%CI2.079~4.700,P<0.001), hypertension(OR3.258，95%CI1.308~8.111，P=0.011), AHI(OR1.071，95%CI1.038~1.105，P<0.001), SaO2(OR0.907，95%CI0.848~0.969，P=0.004) are related with the recurrence ofischemic stroke. which are also the independent risk factors at the same time.Conclusion：OSAHS, obesity and hypertension are the possible independent riskfactors led to the recurrence of non-cardiac ischemic stroke.