溶栓治疗对脑梗死患者睡眠结构的影响  

Effects of thrombolytic therapy on sleep structure in patients with cerebral infarction

作　　者：徐斌 元小冬 薛晶 王连辉 马倩 张萍淑 Xu Bin;Yuan Xiaodong;Xue Jing;Wang Lianhui;Ma Qian;Zhang Pingshu(Department of Neurology,Kailuan General Hospital Affiliated to North China University of Technology,Tangshan City,Hebei Province,063000,China;Hebei Key Laboratory of Neurobiological Function,Tangshan City,Hebei Province,063000,China)

机构地区：[1]华北理工大学附属开滦总医院神经内科,河北省唐山市063000 [2]河北省神经生物机能重点实验室,河北省唐山市063000

出　　处：《现代电生理学杂志》2023年第4期197-201,共5页Journal of Modern Electrophysiology

基　　金：2020年河北省省级科技计划(第六批)项目(203777116D);2020年度河北省医学适用技术跟踪项目(GZ2020002);河北省2020年度医学科学研究课题计划(20201283)。

摘　　要：目的 探究溶栓治疗对脑梗死患者睡眠结构的影响。方法 收集2020年9月至2021年12月在开滦总医院神经内科进行溶栓治疗的急性脑梗死患者作为溶栓组,同时选取此阶段与之年龄、性别等基线资料相匹配的未进行溶栓治疗的急性脑梗死患者作为未溶栓组,选取临床健康查体指标皆正常的志愿者作为正常对照组。记录患者的一般资料、非直接接触式无感睡眠监测系统数据,比较3组研究对象睡眠状态生理指标临床监测结果,采用logistic回归分析筛选睡眠指标。结果 溶栓组与未溶栓组临床基线指标比较,差异均无统计学意义(P>0.05)。溶栓组与未溶栓组总睡眠时间、入睡后清醒时间、R期时间、R期占比、浅睡眠时间及深睡眠时间均高于对照组(P<0.05),睡眠效率低于对照组(P<0.05)。溶栓组总睡眠时间、睡眠效率、R期时间及浅睡眠时间均高于未溶栓组(P<0.05)。多元logistic回归分析结果显示急性脑梗死患者是否进行静脉溶栓治疗与入睡后清醒时间和睡眠效率明显相关,其β值分别为0.020、0.080,Wald值为4.440、31.455,OR值为1.002、1.083,P均?0.05。结论 急性脑梗死可以引发明显的睡眠结构紊乱,而早期给予患者静脉溶栓治疗可以使这种睡眠结构紊乱得到显著改善。Objective To explore the effects of thrombolytic therapy on sleep structure in patients with cerebral infarction.Methods Patients with acute cerebral infarction who received thrombolytic therapy in the Department of Neurology,Kailuan General Hospital from September 2020 to December 2021 were collected as thrombolytic group.Meanwhile,patients with acute cerebral infarction who did not receive thrombolytic therapy and were matched with baseline indexes such as age and gender at this stage were selected as non-thrombolytic group,and volunteers with normal clinical physical examination indexes were selected as normal group.Patients'general information and data from non-contact sensory sleep monitoring system were recorded.The results of clinical monitoring of physiological indicators of sleep state in the three groups were compared,and the sleep indicators were screened by logistic regression analysis.Results There was no significant difference in baseline clinical indexes between the thrombolytic group and the non-thrombolytic group(P>0.05).The total sleep time,wake time after falling asleep,R-phase time,R-phase proportion,light sleep time and deep sleep time in the thrombolytic group and nonthrombolytic group were higher than those in the control group(P<0.05),and the sleep efficiency was lower than that in the control group(P<0.05).Total sleep time,sleep efficiency,R-phase time and light sleep time in the thrombolytic group were higher than those in the non-thrombolytic group(P<0.05).Multivariate logistic regression analysis results showed that whether patients with acute cerebral infarction received intravenous thrombolytic treatment and wake time after falling asleep and sleep efficiency was obviously related,its beta value were 0.020,0.080,Wald value were 4.440,31.455,OR value were 1.002,1.083,all P<0.05.Conclusion Acute cerebral infarction can cause significant sleep disturbances,which can be significantly improved by early intravenous thrombolytic therapy.

关 键 词：脑梗死 睡眠 溶栓治疗 非直接接触式睡眠监测 

分 类 号：R743.3[医药卫生—神经病学与精神病学]