症状性颈内动脉狭窄患者抑郁与睡眠障碍的相关性研究

Relationship of Depression and Sleep Quality of Patients with Cerebral Ischemia and High-grade Atherosclerotic Internal Carotid Artery Stenosis

目的探讨症状性(同侧血管缺血性卒中)颈内动脉重度狭窄患者抑郁与睡眠障碍的相关性。方法根据汉密顿抑郁量表(HAMD)评分,将符合研究标准的症状性颈内动脉狭窄患者分为抑郁组(n=92)和非抑郁组(n=82)。将抑郁组分为轻度抑郁组(n=36)和中度抑郁组(n=56)。运用匹兹堡睡眠质量指数量表(PSQI)评价患者的睡眠状况。对PSQI和HAMD各维度评分进行相关性分析。结果抑郁组患者主观睡眠质量、睡眠潜伏期、睡眠持续性、习惯性睡眠效率、睡眠紊乱、使用睡眠药物、日间功能障碍及PSQI总分均明显高于非抑郁组(P<0.01)。中度抑郁组患者主观睡眠质量、睡眠潜伏期、睡眠紊乱、日间功能障碍及PSQI总分均高于轻度抑郁组(P<0.05)。PSQI各维度中,睡眠紊乱、日间功能障碍与HAMD各维度均明显相关(P<0.01),睡眠潜伏维度及PSQI总分与除体重以外的其他HAMD维度相关(P<0.05)。HAMD各维度中,焦虑/躯体化、认识障碍、睡眠障碍与PSQI各维度评分及PSQI总分相关(P<0.05)。结论症状性颈内动脉狭窄患者抑郁与其睡眠质量密切相关,抑郁程度重者睡眠质量较差。

Objective To explore the relationship of depression and sleep quality of patients with cerebral infarction and high-grade ath-erosclerotic internal carotid artery stenosis in acute seizure phase. Methods The patients targeted to the inclusion criteria were divided into non-depressive group (n=82) and depressive group (n=92) and the depressive group were divided into mild-depressive group (n=36) and moderate-depressive group (n=56) according to the Hamilton Rating Scale for Depressive (HAMD) score. Sleep quality was evaluated with Pittsburgh Sleep Quality Index (PSQI). The correlation was investigated between PSQI and HAMD score. Results The scores in the dimen-sions of subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication and day-time dys-function as well as the PSQI overall score were higher in the depressive group than in the non-depressive group (P<0.01). The scores of sub-jective sleep quality, sleep latency, sleep disturbance, day-time dysfunction and PSQI overall score were higher in the moderate-depressive group than in the mild-depressive group (P<0.05). In PSQI, the sleep disturbance and day-time dysfunction were correlated with all the di-mensions in HAMD (P<0.01), the sleep latency and PSQI overall score were correlated with all the dimensions expect weight in HAMD (P<0.05). In HAMD, anxiety/somatization, cognitive disturbance and sleep disorder were correlated with all the dimensions in PSQI and PSQI overall score (P<0.05). Conclusion The depression condition is closely related to the sleep quality of patients with cerebral infarction and high-grade atherosclerotic internal carotid artery stenosis. The worse the depression, the worse the sleep quality.