维生素D营养状况与卒中相关失眠的相关性研究  

Study on The Correlation Between Vitamin D Nutritional Status and Stroke-Related Insomnia

作　　者：武煦峰[1] 苏洪宝 夏青 WU Xu-feng;SU Hong-bao;XIA Qing(Wuxi People's Hospital,Department of Traditional Chinese Medicine,Wuxi 214023,China;East China Sanatorium Physical Examination Center,Wuxi 214065,China)

机构地区：[1]江苏省无锡市人民医院中医内科,江苏无锡214023 [2]华东疗养院体检中心,江苏无锡214065

出　　处：《中国食物与营养》2023年第6期55-57,66,共4页Food and Nutrition in China

基　　金：2020年上海市卫生和计划生育委员会科研基金(项目编号:20204Y0199)。

摘　　要：目的:探讨维生素D营养状况与卒中相关失眠的相关性。方法:收集2020年6月—2021年6月在我院中医内科就诊的70例脑卒中患者为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表对患者失眠状况进行评估,将PSQI>7分为失眠,根据患者是否失眠,分为失眠组(22例)和对照组(48例)。收集患者年龄、受教育年限等一般信息,以及实验室血清25(OH)D_(3)、钙、磷、同型半胱氨酸(HCY)、C反应蛋白(CRP)、肌酐及尿酸水平数据,将25(OH)D_(3)<20 ng/mL为缺乏、<30 ng/mL为不足、≥30 ng/mL为充足。采用汉密尔顿焦虑(HAMA)量表和汉密尔顿抑郁(HAMD)量表评估患者焦虑和抑郁情况。先对卒中相关失眠危险因素进行单因素分析,将有差异的变量纳入多因素Logistic回归分析,探讨维生素D营养状况与失眠的相关性。结果:失眠组和对照组患者年龄、BMI、户籍、受教育年限、吸烟、高血压、糖尿病、高血脂均无差异,而失眠组患者饮酒者多于对照组,且HAMA及HAMD评分显著高于对照组,而血清25(OH)D_(3)水平显著低于对照组,失眠组维生素D不足/缺乏率高于对照组(均有P<0.05)。多因素分析显示,HAMA、HAMD评分高,血清HCY水平高及存在维生素D不足/缺乏是脑卒中患者失眠的危险因素(P<0.05)。结论:维生素D营养状况差、血清高HCY水平、饮酒、焦虑抑郁均是脑卒中相关失眠的危险因素,在临床上应关注脑卒中患者的血清维生素D水平,以降低失眠率,改善患者预后。Objective To investigate the correlation between vitamin D nutritional status and stroke-related insomnia.Method Totally70 stroke patients attending the Department of Traditional Chinese Medicine at our hospital from June 2020 to June 2021 were collected for this study,and the patients′insomnia status was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale,and PSQI7 was classified as insomnia,and the patients were divided into an insomnia group (22 cases) and a control group (48 cases) according to whether they had insomnia or not.General information such as patients′age,years of education,and laboratory data on serum 25(OH)D_(3),calcium,phosphorus,homocysteine (HCY),C-reactive protein (CRP),creatinine,and uric acid levels were collected,and 25(OH)D_(3)<20 ng/mL was considered deficient,30 ng/mL was considered insufficient,and≥30 ng/mL was considered sufficient.The Hamilton Anxiety(HAMA) scale and the Hamilton Depression (HAMD) scale were used to assess patients'anxiety and depression.The risk factors for strokerelated insomnia were first analyzed univariately,and variables with differences were included in a multifactorial logistic regression analysis to explore the correlation between vitamin D nutritional status and insomnia.Result There were no differences in age,BMI,household registration,years of education,smoking,hypertension,diabetes mellitus,and hyperlipidemia between the insomnia and control groups,while more patients in the insomnia group consumed alcohol than the control group,and HAMA and HAMD scores were significantly higher than the control group,while serum 25(OH)D_(3) levels were significantly lower than the control group,and the rate of vitamin D insufficiency/deficiency was higher in the insomnia group than the control group (all withP<0.05).Multiple Factor analysis showed that high HA-MA and HAMD scores,high serum HCY levels and the presence of vitamin D insufficiency/deficiency were risk factors for insomnia in stroke patients (P<0.05).Conclusion Poor vitamin D nutritional st

关 键 词：维生素D 缺血性脑卒中 失眠 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R740[医药卫生—临床医学] TS201.24[轻工技术与工程—食品科学]