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Objective:To analyze the clinical characteristics of patients suffering from acute ischemic stroke (AIS) complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:Data of patients with AIS who visited the Second Affiliated Hospital of Soochow University from January 2015 to June 2020 and underwent polysomnography monitoring (PSG) in the sleep center were collected retrospectively. Patients were divided into OSAHS group and AIS only group. Demographic information of patients, general clinical data, hematological indicators of glucose and lipid metabolism and inflammatory markers, PSG parameters and neurological function scores were collected, including the National Institutes of Health Stroke Scale (NIHSS) on admission and the modified Rankin Scale (mRS) on discharge. We compared the differences between the two groups. In addition, OSAHS group were divided into good prognosis and poor prognosis subgroups according to mRS score. The differences between the two subgroups were compared.Results:A total of 112 AIS patients combined with OSAHS and 89 AIS only patients were included. The proportion of non-rapid eye movement stages 1+2 [(N1+N2) %], arousal index, the oxygen desaturation index (ODI), percentage of total sleep time with oxygen saturation<90% (TS90) in the OSAHS group were higher than those in the AIS only group, while N3%, lowest nocturnal oxygen saturation (LSaO 2) were lower (all P<0.05). There was no statistical difference in the distribution of cerebral apoplexy lesions (cortex, subcortical, brainstem, cerebellum) between the two groups, but the proportion of patients with multifocal cerebral apoplexy in the OSAHS group was higher ( P=0.032). There was no statistical difference in NIHSS score on admission between the two groups, but the neutrophil/lymphocyte ratio (NLR) score ( P=0.004) and mRS score on discharge ( P=0.010) of the OSAHS group were significantly higher than those in the AIS only group. There were 74 patients in the good prognosis group and 38 in the poor prognosis group. The analysis showed that the NIHSS and NLR scores of the poor prognosis group were higher than the good prognosis group, admission NIHSS score was a risk factor for poor prognosis, all P<0.01. Conclusions:AIS patients complicated with OSAHS are characterized by disordered sleep structure, more severe nocturnal hypoxia, higher risk of developing multiple lesions, poor neurological function recovery at discharge, and high inflammatory index of NLR. Among them, patients with poor prognosis have poorer sleep efficiency, and high admission NIHSS score is a risk factor for poor prognosis.
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Objective:To explore the correlation between fish intake and cognitive function in the elderly.Methods:Based on data for Hubei province of the Chinese Health and Nutrition Survey 2015, 335 participants aged 60 and over were included in the study.Face-to-face cognitive screening was used to evaluate cognitive function.Fish intake was converted into four classifications: 0 g/d, 0-50 g/d, 50-100 g/d, and >100 g/d.The multiple linear regression model was used to analyze the correlation between fish intake and cognitive function in the elderly.Results:There were 335 subjects, including 142 males(42.4%)and 193 females(57.6%). In the overall population( F=4.19, P=0.006)and females( F=2.30, P=0.079), cognitive scores of the elderly increased with increased fish intake, but no increase was found in males( F=1.99, P=0.119). After adjusting for confounding factors such as age, sex, urban and rural living, education level, marital status, smoking, alcohol consumption, daily total energy intake, dietary fat-to-energy intake ratio, BMI, history of hypertension and stroke, fish intake >100 g/d in the elderly was positively correlated with the cognitive score( β=2.68, 95% CI: 0.38-4.98), compared with the lowest fish intake group(0 g/d); gender-stratified analysis showed that the regression coefficient was 4.26(95% CI: 1.23-7.30)for women and 1.70(-1.76-5.15)for men. Conclusions:Increased fish intake is positively correlated with improved cognitive function in elderly women, but the same is not true in elderly men.Increasing fish intake may be beneficial in preventing cognitive decline in elderly women.
ABSTRACT
Sleep-disorderedbreathingarecloselyassociatedwithischemicstroke.Sleep-disordered breathing includes obstructive sleep apnea and central sleep apnea. Studies have show n that obstructive sleep apnea is an independent risk factor for stroke, w hile stroke can also increase the incidence of sleep-disordered breathing. This article review s the latest research progress of sleep-disordered breathing and stroke.