老年缺血性脑卒中后肌张力增高患者睡眠质量调查  

Investigation of sleep quality in elderly patients with hypermyotonia after ischemic stroke

作　　者：张丽 孙瑾 刘美娟 王俊微 杜霞 梁立雯 Zhang Li;Sun Jin;Liu Meijuan;Wang Junwei;Du Xia;Liang Liwen(Department of Neurology,First Affiliated Hospital of Air Force Medical University,Xi′an 710038,China;Department of Cardiology,First Affiliated Hospital of Air Force Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学第一附属医院神经内科,西安710038 [2]空军军医大学第一附属医院心血管内科,西安710038

出　　处：《中华老年多器官疾病杂志》2025年第2期99-103,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(82230065);陕西省自然科学基础研究计划(2020JM-338)。

摘　　要：目的调查老年缺血性脑卒中(IS)后肌张力增高患者睡眠质量及生活质量情况并分析睡眠质量的影响因素。方法采用便利抽样法对2022年1月至2023年6月空军军医大学第一附属医院收治的365例老年IS恢复期肌张力增高患者进行问卷调查,调查内容包括人口学资料、匹兹堡睡眠质量指数(PSQI)、脑卒中专用生活质量量表(SS-QoL)等。根据PSQI得分将患者分为睡眠质量不良组(PSQI≥7分,176例)和睡眠质量良好组(PSQI<7分,182例)。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。使用logistic回归分析评估老年IS恢复期肌张力增高患者睡眠质量不良的影响因素。结果365例患者共回收有效问卷358份,有效回收率为98.08%。358例老年IS恢复期肌张力增高患者PSQI平均得分为(7.20±1.46)分。睡眠质量不良组精力、活动能力、自理、上肢功能维度SS-QOL评分及SS-QOL总分均显著低于睡眠质量良好组,差异有统计学意义(P<0.05)。logistic回归分析显示,肌张力3级(OR=3.357,95%CI 1.766~6.381;P<0.05)、日常活动重度依赖(OR=4.121,95%CI 2.389~7.107;P<0.05)、抑郁表现(OR=2.838,95%CI 1.425~5.652;P<0.05)及维生素D缺乏(OR=2.606,95%CI 1.347~5.043;P<0.05)均为老年IS恢复期肌张力增高患者睡眠质量不良的危险因素。结论老年IS恢复期肌张力严重增强、日常活动能力低下、抑郁情绪及维生素D缺乏可能导致患者睡眠质量下降,影响患者生活质量。Objective To investigate the sleep quality and quality of life in elderly patients with hypermyotonia after ischemic stroke(IS),and to analyze the influencing factors for sleep quality.Methods Convenience sampling was used to screen 365 elderly patients with hypermyotonia during recovery period of IS admitted in First Affiliated Hospital of Air Force Medical University from January 2022 to June 2023.A survey was conducted on them,including demographic data,Pittsburgh sleep quality index(PSQI)and stroke specific quality of life scale(SS-QoL).The patients were divided into poor sleep quality group(PSQI≥7 points,176 cases)and good sleep quality group(PSQI<7 points,182 cases)according to their PSQI score.SPSS 23.0 was used for data analysis.Based on data type,student′s t test or Chi-square test was employed for intergroup comparison.Logistic regression analysis was utilized to identify the influencing factors for poor sleep quality in elderly patients with hypermyotonia during recovery period of IS.Results There were 358 valid questionnaires collected from 365 patients,with an effective recovery rate of 98.08%.The average PSQI score was(7.20±1.46)points in the 358 valid participants.The poor sleep quality group had significantly lower scores of dimensions of energy,activity ability,self-care and upper limb function and total score of SS-QoL than the good sleep quality group(P<0.05).Logistic regression analysis showed that muscular tension grade 3(OR=3.357,95%CI 1.766-6.381;P<0.05),severe dependence on daily activity(OR=4.121,95%CI 2.389-7.107;P<0.05),depression performance(OR=2.838,95%CI 1.425-5.652;P<0.05),and vitamin D deficiency(OR=2.606,95%CI 1.347-5.043;P<0.05)were risk factors for poor sleep quality in elderly patients with hypermyotonia during recovery period of IS.Conclusion Severely intensified muscular tension during recovery period of elderly IS,low daily activity,depression and vitamin D deficiency may lead to a decrease in sleep quality and affect the quality of life of the patients.

关 键 词：老年人 缺血性脑卒中 肌张力 睡眠质量 生活质量 维生素D 

分 类 号：R592[医药卫生—老年医学] R743.3[医药卫生—内科学]