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1.上海市第一人民医院血管外科,上海 200080
2.皖南医科大学基础医学院,安徽 芜湖 241002
邵文怡,E-mail:17614822492@163.com
收稿:2025-11-06,
网络首发:2026-07-31,
纸质出版:2026-08-25
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朱峰,邵文怡,丁凤枝.MRI征象评估阻塞性睡眠呼吸暂停综合征脑血管反应性的临床研究[J].局解手术学杂志,2026,35(08):699-702.
ZHU Feng,SHAO Wen-yi,DING Feng-zhi.Clinical study on MRI features for assessing cerebrovascular reactivity in obstructive sleep apnea syndrome[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(08):699-702.
朱峰,邵文怡,丁凤枝.MRI征象评估阻塞性睡眠呼吸暂停综合征脑血管反应性的临床研究[J].局解手术学杂志,2026,35(08):699-702. DOI: 10.11659/jjssx.11E025039.
ZHU Feng,SHAO Wen-yi,DING Feng-zhi.Clinical study on MRI features for assessing cerebrovascular reactivity in obstructive sleep apnea syndrome[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(08):699-702. DOI: 10.11659/jjssx.11E025039.
目的
2
探讨磁共振成像(MRI)在阻塞性睡眠呼吸暂停综合征(OSAS)患者脑血管反应性(CVR)评估中的应用价值,明确OSAS病程中脑血流调节功能的变化特征。
方法
2
回顾性纳入2023年1月至2024年4月于上海市第一人民医院就诊的37例OSAS患者与23例非睡眠呼吸暂停(NSA)受试者。采集高时间分辨率脑血流量(CBF)及血氧水平依赖(BOLD)-MRI数据,在连续5次24 s屏气刺激的前、中及间歇期同步检测,将多次测量结果取均值计算屏气指数(BHI)以量化CVR。
结果
2
与NSA组相比,OSAS组中基于总CBF计算的BHI(
P
=0.010)及上矢状窦流速BHI(
P
=0.014)显著更高,基于BOLD信号的BHI在全脑(
P
=0.009)、灰质(
P
=0.011)及白质(
P
=0.010)中亦显著升高。亚组分析显示,CVR随OSAS严重程度呈梯度升高,重度OSAS亚组BHI显著高于轻度OSAS亚组及NSA组(
P
<
0.05)。
结论
2
OSAS患者CVR升高是大脑针对间歇性呼吸暂停的代偿性调节机制,可维持氧供稳定;MRI可从全局血流与区域信号两个维度精准评估CVR,为OSAS脑功能损伤的早期识别提供影像学依据。
Objective
2
To explore the application value of magnetic resonance imaging (MRI) in assessing cerebrovascular reactivity (CVR) of patients with obstructive sleep apnea syndrome(OSAS),and to clarify the changing characteristics of cerebral blood flow regulation during the progression of OSAS.
Methods
2
A total of 37 OSAS patients and 23 non-sleep apnea (NSA) subjects who admitted to Shanghai General Hospital from January 2023 to April 2024 were retrospectively enrolled. High‑temporal‑resolution cerebral blood flow (CBF) and blood oxygen level-dependent (BOLD)-MRI data were collected before, during and between 5 consecutive 24-second breath-holding stimuli. The breath-holding index (BHI) was calculated by averaging multiple measurements to quantify CVR.
Results
2
Compared with the NSA group,the OSAS group showed significantly higher BHI derived from total CBF (
P
=0.010) and superior sagittal sinus flow velocity BHI (
P
=0.014),as well as significantly higher BOLD signal-based BHI in the whole brain (
P
=0.009), gray matter (
P
=0.011) and white matter (
P
=0.010). Subgroup analysis showed that CVR increased gradually with the severity of OSAS, and BHI in the severe OSAS subgroup was significantly higher than those in the mild OSAS subgroup and the NSA group (
P
<
0.05).
Conclusion
2
Elevated CVR in OSAS patients is a cerebral compensatory regulatory mechanism for intermittent apnea to maintain stable oxygen supply.MRI can accurately evaluate CVR from two dimensions of global blood flow and regional signal, providing imaging evidence for early identification of OSAS-related brain function injury.
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