新发无症状性脑梗死患者一年内睡眠障碍的影响因素分析  

Influencing factor analysis of sleep disorders within one year after new onset of silent brain infarction

作　　者：曾婷 谭华 Zeng Ting;Tan Hua(Department of Neurology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川省绵阳市中心医院神经内科,621000 [2]西南医科大学附属医院神经内科

出　　处：《中国脑血管病杂志》2022年第6期376-385,共10页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨无症状性脑梗死(SBI)后2周及1年睡眠障碍的发生和变化情况,并分析SBI急性期与慢性期发生睡眠障碍的影响因素。方法前瞻性连续纳入2017年8月至2019年2月西南医科大学附属医院神经内科以头晕、头痛等非特异性症状为主诉的SBI住院患者125例。依据纳入与排除标准,对入组患者分别于发病后2周(急性期)、1年(慢性期)进行匹兹堡睡眠质量指数(PSQI)量表评分,并依此评分结果将SBI患者分为睡眠障碍组(PSQI量表评分>7分)和非睡眠障碍组(PSQI量表评分≤7分)。收集两组患者的社会人口学资料,包括年龄、性别、受教育年限、婚姻状况(已婚或独身)、性格特点(内向或外向)、职业(体力劳动或脑力劳动)、个人月收入(<2000元或≥2000元);脑血管病危险因素,包括吸烟、饮酒史,高血压病、糖尿病、冠心病、心房颤动史;血液生化指标,包括血脂、尿酸及同型半胱氨酸;影像学资料,包括病灶的侧别(单纯左侧大脑半球或非单纯左侧大脑半球)、部位(额、顶、颞、枕叶、基底节区、丘脑、脑干、小脑)、数量[单发病灶、多发病灶(病灶数≥2个)]、是否合并脑白质病变;量表评定指标,包括汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、蒙特利尔认知评估量表(MoCA)、改良淡漠评定量表(MAES)及PSQI量表[总分及其参评的7项(睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠紊乱、催眠药物使用及日间功能障碍)评分]。SBI后1年门诊随访时调查使用抗焦虑抑郁药物、发生卒中事件情况。分别于SBI后2周、1年比较睡眠障碍组与非睡眠障碍组患者的临床资料及量表评分结果,并结合临床上与睡眠障碍密切相关的因素分析不同因素对急性期和慢性期患者发生睡眠障碍的影响。结果(1)125例SBI患者中,依据标准排除28例,最终纳入97例进行分析。97例患者中,SBI后2周,睡眠障碍组36例,睡眠障碍Objective To investigate the occurrence and changes of sleep disorders 2 weeks and 1 year after silent brain infarction(SBI)and influencing factors for sleep disorders in acute and chronic phases of SBI.Methods A total of 125 inpatients with SBI complained of non-specific symptoms such as dizziness and headache in the Department of Neurology,Affiliated Hospital of Southwest Medical University from August 2017 to February 2019 were included prospectively.According to the inclusion and exclusion criteria,the selected patients were assessed with the Pittsburgh sleep quality index(PSQI)2 weeks(acute phase)and 1 year(chronic phase)after the onset of disease.According to PSQI scores,SBI patients were divided into the sleep disorder group(PSQI score>7 points)and the non-sleep disorder group(PSQI score≤7 points).Socio-demographic data of patients in the two groups were collected,including age,gender,educated-years,marital status(married or single),personality traits(inward or outward),occupation(manual/mental labor),and monthly persona l income(<2,000 yuan or≥2,000 yuan).Risk factors for cerebrovascular diseases included smoking and drinking history,hypertension,diabetes,coronary heart disease,atrial fibrillation history.Blood biochemical indicators included blood lipids,uric acid and homocysteine.Imaging data included the side of lesion(pure left cerebral hemisphere or non-pure left cerebral hemisphere),location(frontal,parietal,temporal,occipital,basal ganglia,thalamus,brain stem and cerebellum),number(single lesion,multiple lesions[number of lesions≥2]),and whether cerebral white matter lesions were combined.Rating indicators of the scale included Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),Montreal cognitive assessment scale(MoCA),modified indifference rating scale(MAES)and PSQI scale(total score and scores of seven items participating in the evaluation[sleep quality,sleep latency,sleep time,sleep efficiency,sleep disorder,hypnotic drug use and daytime dysfunction]).The use of anti-anxiety and

关 键 词：脑梗死 无症状性脑梗死 睡眠障碍 发生率 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]