轻度创伤性脑损伤患者日间过度嗜睡的相关危险因素  

Related risk factors of sleep-wake disturbances in patients with mild traumatic brain injury combined with pain

作　　者：赵强[1] 彭涛[1] 魏海棠[1] 肖敏 ZHAO Qiang;PENG Tao;WEI Hai-tang;无(Department of Rehabilitation,Hankou Hospital of Wuhan City,Hubei Province,Wuhan 430015,China;Department of Thyroid and Breast Surgery,Wuhan Red Cross Hospital,Wuhan 430012,China)

机构地区：[1]湖北省武汉市汉口医院康复科,湖北武汉430015 [2]湖北省武汉市红十字会医院甲乳外科,湖北武汉430012

出　　处：《吉林医学》2023年第2期311-315,共5页Jilin Medical Journal

基　　金：武汉市卫生和计划生育委员会科研项目[项目编号:WX18Z10]。

摘　　要：目的:分析轻度创伤性脑损伤(mTBI)患者发生日间过度嗜睡(EDS)的相关危险因素。方法:前瞻性观察研究,于2018年1月~2020年12月在武汉市汉口医院招募89例mTBI患者,根据Epworth嗜睡量表(ESS)评分,分为EDS组62例(ESS评分≥10分)与非EDS组27例(ESS评分<10分)。采用手表式活动记录仪(Actiwatch)追踪两组的睡眠参数,连续7 d,监测结束时加以匹兹堡睡眠质量指数量表(PSQI)调查睡眠情况,同时辅以睡眠日记。采用Wilcoxon秩和检验、Pearsonχ^(2)检验或t检验分析两组的一般资料,取P<0.05的变量进入二元Logistic回归分析,从而筛选出与mTB患者EDS相关的危险因素。结果:单因素分析结果显示,焦虑、抑郁、疼痛和工作能力变化与EDS相关。多因素分析结果显示:焦虑是mTBI患者发生EDS唯一的独立危险因素(OR=12.681;95%CI:2.209~72.805;P=0.004)。结论:对于合并焦虑的mTBI患者,医师要高度警惕EDS的发病风险,必要时可提供一定的预防和干预措施。Objective To investigate the association between sleep-wake disturbance and pain after mTBI.Method In this prospective study,89 patients with mTBI were recruited from the Rehabilitation Science Department of Hankou Hospital in Wuhan from January 2018 to December 2020.According to the score of Epworth Sleepiness Scale(ESS),62 patients were divided into EDS group(ESS score≥10 points)and 27 patients in non-EDS group(ESS score<10 points)and were included in the study queue.The sleep parameters of the two groups were tracked by the watch activity recorder(activwatch)for 7 days.At the end of the monitoring,the Pittsburgh Sleep Quality Index(PSQI)was used to investigate the sleep status,and the sleep diary was also used.The general data of the two groups were analyzed by wilcoxon rank sum test,Pearson c2 test or t-test,and the variables of P<0.05 were entered into the binary logistic regression analysis to screen out the risk factors related to EDS in patients with mTB.Results The results of univariate analysis showed that anxiety,depression,pain and changes in work ability were related to EDS.Multivariate analysis showed that anxiety was the only independent risk factor for EDS in mTBI patients(OR=12.681;95%CI:2.209~72.805;P=0.004).Conclusion For mTBI patients with anxiety,doctors should pay high attention to the risk of EDS and provide certain prevention and intervention measures if necessary.

关 键 词：脑损伤 创伤性 睡眠 危险因素 前瞻性研究 

分 类 号：R651.15[医药卫生—外科学]