自主神经功能障碍对卒中后睡眠障碍的影响  

Effect of autonomic dysfunction on sleep disorders after stroke

作　　者：翁汉育 袁淑兰[2] 陈仰昆 WENG Hanyu;YUAN Shulan;CHEN Yangkun(Graduate School,Guangdong Medical University,Zhanjiang 524000,China;Dongguan People’s Hospital,Dongguan 523000,China)

机构地区：[1]广东医科大学研究生院,广东湛江524000 [2]东莞市人民医院,广东东莞523000

出　　处：《中国实用神经疾病杂志》2023年第8期958-962,共5页Chinese Journal of Practical Nervous Diseases

基　　金：广东省科技发展专项基金项目(编号:2017A020215002)。

摘　　要：目的探讨急性脑卒中睡眠觉醒障碍的早期诊断与自主神经系统(ANS)功能障碍的关系。方法本研究是一项横断面观察研究,使用Ewing试验评估ANS功能障碍的严重程度,并应用PSQI评分评估脑卒中后3个月的失眠程度。分析首次缺血性脑卒中后自主神经系统功能变化与睡眠障碍的相关性。将缺血性卒中患者的脑成像标志物与自主神经系统(ANS)功能障碍联系起来,分析缺血性卒中合并ANS功能障碍、睡眠障碍对预后的影响以及相关因素。结果本研究共纳入52例急性缺血性脑卒中患者,其中男44例(84.6%),年龄(58.85±9.52)岁。ANS功能障碍的比例高达90.4%,10例(19.2%)严重ANS功能障碍患者在脑干卒中患者中睡眠障碍的发生率最高。经过3个月的随访,发现与非严重ANS功能障碍组相比,严重ANS功能障碍组的神经功能障碍和日常生活能力受损更严重,但未发现严重的ANS功能障碍与睡眠障碍之间的联系。结论急性缺血性脑卒中普遍存在ANS功能障碍,尚未发现严重的ANS功能障碍与睡眠障碍之间的关系。ANS调节可能是急性缺血性脑卒中的一个治疗方向。Objective To explore the relationship between early diagnosis of sleep arousal disorder and autonomic nervous system(ANS)dysfunction in acute stroke.Methods This study is a cross-sectional observation study that uses the Ewing test to assess the severity of ANS dysfunction and the PSQI score to assess the degree of insomnia 3 months after stroke.Correlation analysis of autonomic nervous system function changes and sleep disorders after the first ischemic stroke.Associating the brain imaging biomarkers of ischemic stroke patients with ANS dysfunction,the impact of ischemic stroke combined with ANS dysfunction,sleep disorders on prognosis,and related factors were analyzed.Results A total of 52 patients with acute ischemic stroke were included in this study,including 44 males(84.6%)with an age of(58.85±9.52)years old.The proportion of ANS dysfunction is as high as 90.4%,with 10 patients(19.2%)with severe ANS dysfunction having the highest incidence of sleep disorders among brainstem stroke patients.After a 3-month follow-up,it was found that compared to the non-serious ANS dysfunction group,the severe ANS dysfunction group had more severe neurological dysfunction and impaired daily living ability.However,no association was found between severe ANS dysfunction and sleep disorders.Conclusion ANS dysfunction is commonly present in acute ischemic stroke,and the relationship between severe ANS dysfunction and sleep disorders has not been found yet.ANS regulation may be a therapeutic direction for acute ischemic stroke.

关 键 词：缺血性脑卒中 自主神经功能障碍 Ewing试验 睡眠障碍 失眠 

分 类 号：R743.33[医药卫生—神经病学与精神病学]