失眠患者伴发脑白质高信号的危险因素分析  

Analysis of risk factors for white matter hyperintensities in patients with insomnia

作　　者：李焕国 叶发 晁红艳 李志平 崔凤[1] LI Huanguo;YE Fa;CHAO Hongyan;LI Zhiping;CUI Feng(Department of Radiology,Affiliated Hangzhou TCM Hospital,Zhejiang Chinese Medical University,Hangzhou 310007,CHINA)

机构地区：[1]浙江中医药大学附属杭州市中医院放射科,浙江杭州310007 [2]浙江中医药大学附属杭州市中医院临床心理科

出　　处：《江苏医药》2024年第12期1213-1216,1224,共5页Jiangsu Medical Journal

基　　金：浙江省中医药科技计划项目(2022ZB233)。

摘　　要：目的分析失眠患者伴发脑白质高信号(WMH)的危险因素。方法根据头颅MRI检查结果,失眠患者219例分为伴发WMH组(A组,112例)和不伴发WMH组(B组,107例)。比较两组临床资料、实验室血液指标和汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、失眠严重程度指数量表(ISI)及护士用自杀风险评估量表(NGASR)评分,分析失眠患者伴发WMH的危险因素。结果两组年龄、并发高血压和糖尿病比例、受教育程度比较有统计学差异(P<0.05或P<0.01)。两组HAMA、HAMD及NGASR评分比较无统计学差异(P>0.05)。A组ISI评分高于B组(P<0.05)。A组血清尿酸(SUA)升高及D-二聚体异常比例均高于B组(P<0.01)。年龄较大和SUA升高是失眠患者伴发WMH的独立危险因素(P<0.01)。结论年龄较大和SUA升高是失眠患者伴发WMH的独立危险因素。Objective To analyze the risk factors for the white matter hyperintensities(WMH)in the patients with insomnia.Methods According to the results of head MRI examination,219 patients with insomnia were divided into two groups of A(with WMH,112 cases)and B(without WMH,107 cases).The clinical data and laboratory blood indicators of the two groups were compared.The scores of Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),insomnia severity index(ISI)and nurses'global assessment of suicide risk(NGASR)were compared between the two groups.The risk factors for WMH in the patients with insomnia were analyzed.Results There were significant differences in age,the proportions of the patients with hypertension and diabetes,and educational level between the two groups(P<0.05 or P<0.01).There were no significant differences in the sores of HAMA,HAMD and NGASR between the two groups(P>0.05).ISI score of group A was higher than that of group B(P<0.05).The proportions of the patients with increased serum uric acid(SUA)and D-dimer abnormality in group A were higher than those in group B(P<0.01).Older age and increased SUA were the independent risk factors for WMH in the patients with insomnia(P<0.01).Conclusion Older age and elevated SUA are the independent risk factors for WMH in the patients with insomnia.

关 键 词：失眠 脑白质高信号 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学]