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. 2025 Apr;39(4):368-375.
doi: 10.13201/j.issn.2096-7993.2025.04.014.

[Analysis of the incidence and influencing factors of collateral circulation in high-risk patients with sleep apnea complicated with stroke treated by continuous positive pressure ventilation]

[Article in Chinese]
Linna Zhu  1 , Yanli Zhou  1 , Yang Zhang  1 , Yaling Liu  1
Affiliations

[Analysis of the incidence and influencing factors of collateral circulation in high-risk patients with sleep apnea complicated with stroke treated by continuous positive pressure ventilation]

[Article in Chinese]
Linna Zhu et al. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr.

Abstract
in English, Chinese

Objective:To investigate the incidence of collateral circulation in high-risk patients with sleep apnea and stroke treated by continuous positive airway pressure （CPAP） ventilation and to analyze the influencing factors. Methods:A total of 152 patients diagnosed with obstructive sleep apnea-hypopnea syndrome （OSAHS） combined with acute ischemic stroke （AIS） who were admitted to our hospital from January 2020 to June 2022 were selected for this study. Based on the apnea-hypopnea index （AHI）, the patients were divided into three groups: mild （n=44）, moderate （n=72）, and severe （n=36）. After treatment, the patients were further classified into a group without collateral circulation （n=30） and a group with collateral circulation （n=26）, which included those with moderate collateral circulation （n=69） and good collateral circulation （n=27）. Clinical data across the different groups were compared, and multiple factor analysis was performed to identify factors affecting the occurrence of collateral circulation. Results:The AHI and IL-6 levels in the severe group were significantly higher than those in the mild and moderate groups, while the levels of NO and PO2 were significantly lower in the severe group compared to the mild and moderate groups, with statistically significant differences among the three groups （P<0.05）. After treatment, all groups showed improvement, and the proportion of patients with collateral circulation was 84.09% in the mild group, 81.94% in the moderate group, and 72.22% in the severe group. Significant differences in age, AHI, NIHSS, NO, MoCA, and MMSE scores were observed between the groups with and without collateral circulation （P<0.05）. In the group with collateral circulation, the scores for age, AHI, and NIHSS in the good collateral circulation subgroup were significantly lower than those in the poor collateral circulation and moderate collateral circulation subgroups, while the scores for NO, MoCA, and MMSE were significantly higher in the good collateral circulation subgroup. Multi-factor analysis revealed that age, AHI, and NIHSS were independent risk factors for collateral circulation, whereas NO, MoCA, and MMSE served as protective factors that were negatively correlated with collateral circulation. Classification tree model results indicated that AHI had the greatest influence on the occurrence of collateral circulation among the five influencing factors, demonstrating good predictive capability. Conclusion:Most high-risk patients with sleep apnea and stroke are likely to develop collateral circulation following continuous positive airway pressure ventilation. Factors such as age, AHI, NIHSS, NO, MoCA, and MMSE are important determinants affecting the occurrence of collateral circulation.

目的：探讨睡眠呼吸暂停合并卒中高危人群经持续正压通气治疗侧支循环发生情况及影响因素分析。 方法：选取2020年1月-2022年6月郑州人民医院收治的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并脑卒中患者152例作为研究对象，根据患者睡眠呼吸暂停低通气指数（AHI）将患者分为轻度组（n=44），中度组（n=72）和重度组（n=36），治疗后根据患者是否发生侧支循环将患者分为无侧支循环组（n=30）和有侧支循环组（n=122），根据侧支循环程度分为侧支循环较差（n=26）、侧支循环中等（n=69）、侧支循环良好（n=27），比较不同组患者临床资料，多因素分析影响患者发生侧支循环的因素。 结果：重度组患者AHI和IL-6水平显著高于轻度组和中度组，NO和PO2水平则显著低于轻度组和中度组，3组患者之间的差异有统计学意义（P<0.05），治疗后，各组患者均有所好转，轻度组、中度组和重度组发生侧支循环的人数占比分别为84.09%，81.94%和72.22%。有侧支循环组和无侧支循环组在年龄、AHI、NIHSS、NO、MoCA、MMSE方面的差异有统计学意义（P<0.05）。有侧支循环组中，侧支循环良好组年龄、AHI、NIHSS评分显著低于侧支循环较差和侧支循环中等组，NO水平、MoCA评分、MMSE评分显著高于侧支循环较差和侧支循环中等组。多因素分析结果显示，年龄、AHI、NIHSS是侧支循环发生的独立危险因素，NO、MoCA、MMSE是侧支循环发生的保护因素，与侧支循环发生呈负相关。分类树模型结果显示，以上5个影响因素中，AHI对患者发生侧支循环的影响最大。经检验，该模型的预测效果良好。 结论：睡眠呼吸暂停合并卒中高危人群经持续正压通气治疗后大部分患者会发生侧支循环，年龄、AHI、NIHSS、NO、MoCA、MMSE是影响侧支循环发生的重要因素。.

Keywords: acute ischemic stroke; collateral circulation; continuous positive airway pressure; obstructive sleep apnea hypopnea syndrome.

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Conflict of interest statement

The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Figures

图 1
图 1
患者发生侧支循环风险分类树模型
图 2
图 2
决策树模型增益图和指数图
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References

    1. 龚 琴, 王 海燕, 谢 晓玮, et al. 中重度阻塞性睡眠呼吸暂停低通气综合征的危险因素分析及风险预测模型的构建. 现代生物医学进展. 2023;23(17):3268-3272, 3262.
    1. Li SY, Zheng W, Wang X, et al. The impact of obstructive sleep apnea and comorbidity status on cardiovascular outcomes in patients with acute coronary syndrome. Nutr Metab Cardiovasc Dis. 2023;33(12):2372–2383. - PubMed
    1. 王 连辉, 元 小冬, 徐 斌, et al. 阻塞性睡眠呼吸暂停低通气综合征与卒中. 实用心脑肺血管病杂志. 2023;31(6):122–126.
    1. Scanning Retracted: Effects of Obstructive Sleep Apnea-Hypopnea Syndrome and Cognitive Function in Ischemic Stroke Based on Linear Regression Equation. Scanning. 2023;2023:9763714. - PMC - PubMed
    1. Ji P, Kou Q, Qu X, et al. Effects of Obstructive Sleep Apnea-Hypopnea Syndrome and Cognitive Function in Ischemic Stroke Based on Linear Regression Equation. Scanning. 2022;2022:4105169. - PMC - PubMed

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