clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2025-103-3-196-201clinmed-1094Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSНарушение зрительно-конструктивных и исполнительных навыков у пациентов с синдромом апноэ сна в остром периоде ишемического инсультаDisturbance of visuospatial and executive functions in patients with sleep apnea syndrome in the acute period of ischemic strokehttps://orcid.org/0000-0002-5210-7593СереброваЕ. В.SerebrovaE. V.

Сереброва Екатерина Вячеславовна — канд. мед. наук, старший преподаватель кафедры неврологии и нейрохирургии с курсами медицинской реабилитации, психиатрии, ФПКиП

Гомель

Ekaterina V. Serebrova — Candidate of Medical Sciences, Senior Lecturer at the Department of Neurology and Neurosurgery with courses in Medical Rehabilitation, Psychiatry, Faculty of Advanced Training and Retraining

Gomel

Гомельский государственный медицинский университетБеларусьGomel State Medical UniversityBelarus2025030720251033196201Copyright © Сереброва Е.В., 20252025Сереброва Е.В.Serebrova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1094

У пациентов с инфарктом мозга (ИМ) и синдромом апноэ сна (САС) нейрокогнитивные расстройства являются частым симптомом, что определяет актуальность совершенствования их ранней диагностики и лечения. Проведено проспективное динамическое исследование нарушений зрительно-конструктивных и исполнительных навыков (ЗКИН) у 74 пациентов с САС (основная группа) и 36 пациентов без САС (группа сравнения) в остром периоде ИМ при помощи исследования тестов построения маршрута (ТПМ), копирования куба (ТКК) и рисования часов (ТРЧ). Установлено, что у пациентов с САС в первые 72 ч ИМ наблюдаются более тяжелые расстройства ЗКИН, главным образом за счет нарушения выполнения ТРЧ, и худшее их восстановление через месяц в сравнении с пациентами без САС (р < 0,05). Для ТРЧ получены хорошие показатели ранней диагностики нарушений ЗКИН у пациентов с САС и ИМ (AUC — 0,926 (95% ДИ 0,86‒0,97; р < 0,0001), чувствительность — 100,0% (95% ДИ 84,6‒100,0), специфичность — 85,23% (95% ДИ 76,1‒91,90). У пациентов с тяжелой степенью САС установлены самые низкие оценки ЗКИН, ТПМ и ТРЧ (р < 0,05), а также выявлены умеренные отрицательные связи между оценкой ТРЧ и показателями индекса апноэ-гипопноэ и индекса десатурации (p < 0,001). У 20 пациентов, получавших терапию постоянным положительным давлением в дыхательных путях (СИПАП-терапию) установлена положительная динамика оценки ЗКИН (р < 0,05), чего не отмечено в подгруппе без аналогичного лечения, что позволяет сделать вывод о положительном влиянии СИПАП-терапии на восстановление в данной когнитивной сфере

In patients with cerebral infarction (CI) and sleep apnea syndrome (SAS), neurocognitive disorders are a common symptom, which underscores the relevance of improving their early diagnosis and treatment. A prospective dynamic study was conducted on disorders of visual-constructive and executive skills (VCES) in 74 patients with SAS (main group) and 36 patients without SAS (comparison group) during the acute period of CI using route-building tests (RBT), cube copying tests (CCT), and clock drawing tests (CDT). It was found that patients with SAS exhibited more severe VCES disorders within the fi rst 72 hours of CI, primarily due to impaired performance on the CDT, and worse recovery after one month compared to patients without SAS (p < 0.05). The CDT showed good indicators for the early diagnosis of VCES disorders in patients with SAS and CI (AUC — 0.926 (95% CI 0.86–0.97; p < 0.0001), sensitivity — 100.0% (95% CI 84.6–100.0), specifi city — 85.23% (95% CI 76.1–91.90). In patients with severe SAS, the lowest scores for VCES, RBT, and CDT were established (p < 0.05), and moderate negative correlations were identifi ed between the CDT scores and the apnea-hypopnea index and desaturation index (p < 0.001). Among 20 patients receiving CPAP therapy, a positive dynamics in VCES scores was noted (p < 0.05), which was not observed in the subgroup without similar treatment, suggesting a positive eff ect of CPAP therapy on recovery in this cognitive domain

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The authors declare that there are no conflicts of interest present.