急性脑梗死后睡眠障碍发生的相关因素及其对患者认知功能障碍的影响  

Factors associated with the occurrence of sleep disturbanceafter acute cerebral infarction and their influenceon cognitive dysfunction in patients

作　　者：杜田田 郑献召[1] 张燕[2] 张三军[1] DU Tiantian;ZHENG Xianzhao;ZHANG Yan;ZHANG Sanjun(Jiaozuo People's Hospital,Department of Neurology,Jiaozuo 454000,China;Jiaozuo People's Hospital,Neuroelectrophysiology Room,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院神经内科,河南焦作454000 [2]焦作市人民医院神经电生理室,河南焦作454000

出　　处：《黑龙江医药科学》2025年第4期89-93,共5页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关计划项目,编号:LHGJ20240704。

摘　　要：目的:探究急性脑梗死后睡眠障碍发生的相关因素及其对患者认知功能障碍的影响。方法:选取焦作市人民医院2021年1月至2023年12月收治的180例急性脑梗死患者,通过查询电子病历的方式收集所有患者基础资料,所有患者采用匹兹堡睡眠质量量表(PSQI)评估睡眠质量,采用蒙特利尔认知评估量表(MoCA)和简易智力状态检查量表(MMSE)评估认知功能,并根据评估结果将上述患者分为睡眠障碍组与无睡眠障碍组,比较两组睡眠结构参数差异,分别采用单因素与多因素Logistic回归分析法筛选造成急性脑梗死患者发生睡眠障碍的危险因素,比较两组认知功能差异,采用MedCalc分析急性脑梗死患者睡眠质量、睡眠结构与认知功能间的相关性。结果:(1)180例患者中,睡眠障碍发生率为48.33%(87/180);(2)睡眠障碍组睡眠潜伏期、觉醒时间长于无睡眠障碍组,睡眠总时间短于无睡眠障碍组,睡眠效率低于无睡眠障碍组(P<0.05);(3)单因素分析结果显示,睡眠障碍组患者年龄、日常生活能力评分低于无睡眠障碍组,高中和大专及以上文化水平、脑力劳动、梗死部位为脑叶梗死占比均高于无睡眠障碍组,神经功能、焦虑情绪、抑郁情绪评分均高于无睡眠障碍组(P<0.05);(4)多因素分析结果显示,脑叶梗死、神经功能与日常生活能力偏低、焦虑及抑郁情绪是造成急性脑梗死患者发生睡眠障碍的危险因素(P<0.05);(5)睡眠障碍组MoCA、MMSE得分均低于无睡眠障碍组(P<0.05);(6)MedCalc分析结果显示,PSQI、睡眠潜伏期、觉醒时间与MoCA、MMSE呈负相关,睡眠效率、睡眠总时间与MoCA、MMSE呈正相关(P<0.05)。结论:急性脑梗死患者睡眠障碍发生率较高,脑叶梗死、神经功能和日常生活能力偏低、存在焦虑抑郁情绪是造成睡眠障碍的危险因素,且睡眠障碍与患者认知功能改变密切相关,临床应加强对急性脑梗死患者睡眠障碍的评估与�Objective:To explore the factors related with the occurrence of sleep disturbance after acute cerebral infarction and its influence on cognitive dysfunction in patients.Methods:The 180 patients with acute cerebral infarction admitted to Jiaozuo People’s Hospital from January 2021 to December 2023,All patient basic data were collected by inquiring about the electronic medical records,All patients were assessed by sleep quality using the Pittsburgh Sleep Quality Scale(PSQI),Cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA)and the Summary Mental State Examination Scale(MMSE),According to the evaluation results,the above patients were divided into sleep disorder group and physical sleep disorder group,Comparing the differences in sleep structure parameters between the two groups,Univariate and multivariate Logistic regression analysis were used to screen risk factors for sleep disturbance in patients with acute cerebral infarction,Comparing the differences in cognitive function between the two groups,Correlation between sleep quality,sleep structure and cognitive function in patients with acute cerebral infarction by MedCalc.Results:(1)Among the 180 patients,Sleep disturbance occurred in 87 patients,The incidence of sleep disorders was 48.33%(87/180);(2)Sleep latency and awakening time in the sleep disorder group than in the group without sleep disorder,The total sleep duration was shorter than that in the no-sleep disorder group,Sleep efficiency was lower than that in the group without sleep disorder(P<0.05);(3)The results of the univariate analysis showed that,Patient age and daily living ability score in the sleep disorder group were lower than those in the no sleep disorder group,High school and college or above education level,mental work,infarction site,the proportion of cerebral lobe infarction is higher than the group without sleep disorders,Neurological function,anxiety,and depression mood scores were higher than those of the group without sleep disorders(P<0.05);(4)The re

关 键 词：急性脑梗死 睡眠障碍 影响因素 认知功能 

分 类 号：R743[医药卫生—神经病学与精神病学]