Study On The Association Between Obstructive Sleep Apnea Hypopnea Syndrome And Acute Small Artery Occlusive Cerebral Infarction

ObjectiveTo explore the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS)and acute small artery occlusive cerebral infarction by retrospective analysis.Materials and methods141 patients who were diagnosed as acute arteriolar occlusive cerebral infarction in the Third Affiliated Hospital of Southern Medical University from January 2020 to November 2022 and completed polysomnography monitoring were selected into the observation group.They was divided into non-OSAHS,mild OSAHS and moderatesevere OSAHS groups according to different AHI values.At the same time,we chose 104 patients as control group who were admitted for general check-up and had completed polysomnography monitoring.The clinical indicators include name,gender,age,body mass index,with or without drinking history,with or without smoking history,with or without carotid atherosclerosis,with or without hypertension,with or without diabetes,with or without coronary heart disease.Blood indicators include blood lipids,uric acid and homocysteine.Brain magnetic resonance imaging data and sleep related indicators also were recorded.SPSS26.0 statistical analysis software was applied to demonsrate the correlation of all related factors.Results1.Statistical analysis of basic data between the observation group and the control groupSignificant differences of year,smoking,hypertension,diabetes,carotid atherosclerosis,high density lipoprotein,homocysteine level and OSAHS were found between the observation and the control group.2.Logistic regression analysis of the risk factors for acute small artery occlusive cerebral infarctionAccording to the results of univariate analysis,the independent variables of P<0.05,were included in the binary logistic regression model.The results showed that there was a significant correlation between thehypertension,carotid atherosclerosis,OSAHS and acute small artery occlusive cerebral infarction After adjusting confounding factors,3.Univariate analysis of the risk factors for acute small artery occlusive cerebral infarction in the OSAHS group and non-OSAHS groupAmong 141 acute small artery occlusive cerebral infarction,122 cases were OSAHS and 19 cases were without OSAHS.Compared with the non-OSAHS group,the BMI,homocysteine level and the prevalence of carotid atherosclerosis were higher,the longest time of hypopnea,the longest time of apnea,percentage of oxygen saturation<90%of total recording time(TSTSaO2<90%)and sleep latency were longer,while the non-rapid eye movement two was shorter,the mean nocturnal oxygen saturation(MSaO2),and the lowest nocturnal oxygen saturation(LSaO2)were lower in the OSAHS group.4.Logistic regression analysis of the risk factors for acute small artery occlusive cerebral infarction with OSAHSLogistic regression analysis showed that there was a significant correlation between BMI,the longest time of apnea,the lowest nocturnal oxygen saturation and acute small artery occlusion cerebral infarction with OSAHS.5.Univariate analysis of the factors for small artery occlusive cerebral infarction in the non-OSAHS,mild OSAHS and moderate-severe OSAHS groupAmong 141 acute small artery occlusive cerebral infarction,19 cases were nonOS AHS,42 cases were mild OSAHS and 80 cases were moderate-severe OSAHS.Among them,BMI,homocysteine level,carotid atherosclerosis,the longest time of hypopnea and percentage of oxygen saturation<90%of total recording time were gradually increased,while the lowest nocturnal oxygen saturation was gradually decreased.6.Correlation between BMI,homocysteine level,carotid atherosclerosis and AHI,LSaO2,TSTSaO2<90%BMI was positively related to TSTSaO2<90%(r=0.423,P<0.01)and AHI(r=0.418,P<0.01),while negatively related to LSaO2(r=-0.696,P<0.01).Homocysteine was positively related to TSTSaO2<90%(r=0.233,P<0.01)and AHI(r=0.329,P<0.01),while negatively related to LSaO2(r=-0.696,P<0.01).There is only a positively correlation between the carotid atherosclerosis and AHI(r=0.173,P<0.05).7.The comparison of cerebral infarction locations between the OSAHS group and the non-OSAHS groupThere is no statistical difference in the infarction location between the OSAHS group and the non-OSAHS group in acute small artery occlusion cerebral infarction.Conclusions1.The incidence of OSAHS among the acute small artery occlusion cerebral infarction is 86.5%.OSAHS is an independent risk factor for the occurrence of acute small artery occlusion cerebral infarction.2.Among the acute small artery occlusive cerebral infarction patients,BMI,homocysteine,carotid atherosclerosis,the longest time of hypopnea,longest time of apnea,TSTSaO2<90%,LSaO2,and MSaO2 are related to OSAHS.In all of these factors,longest time of hypopnea,BMI and LSaO2 may were independent risk factors for OSAHS.3.BMI,homocysteine,carotid atherosclerosis,the longest time of hypopnea,and TSTSaO2<90%were positively correlated with the severity of OSAHS,while the LSaO2 was negatively ralated to the severity of OSAHS.4.Sleep structure of acute small artery occlusive cerebral infarction will be disturbed by OSAHS,with its sleep characteristics of longer sleep latency and shorter NREM2.