脑梗死并发睡眠呼吸障碍患者焦虑状态及其与睡眠质量的相关性

Anxiety of Cerebral Infarction Patients with Sleep-disordered Breathing and Correlated with Sleep Quality

目的探讨脑梗死并发睡眠呼吸障碍患者焦虑状态及其与睡眠质量的关系。方法急性期脑梗死病例149例分为无睡眠呼吸障碍组(95例)和睡眠呼吸障碍组(54例),运用汉密顿焦虑量表(HAMA)和匹兹堡睡眠质量指数量表(PSQI)评价两组患者的焦虑状态和睡眠质量,并对睡眠呼吸障碍组HAMA和PSQI评分进行相关性分析。结果睡眠呼吸障碍组HAMA总分及躯体焦虑、精神焦虑因子分均显著高于无睡眠呼吸障碍组(P<0.001)。躯体焦虑各组成因子中,睡眠呼吸障碍组感觉系统、心血管系统、胃肠系统、植物神经系统等因子评分高于无睡眠呼吸障碍组(P<0.05)。精神焦虑各因子中,睡眠呼吸障碍组焦虑心境、紧张、害怕、失眠、抑郁心境等因子评分高于无睡眠呼吸障碍组(P<0.05)。睡眠呼吸障碍组PSQI总分及各因子分显著高于无睡眠呼吸障碍组(P<0.001)。HAMA总分及躯体焦虑、精神焦虑评分与PSQI总分具有显著相关性(P<0.001)。躯体焦虑评分与主观睡眠质量、睡眠潜伏期、睡眠紊乱、日间功能障碍评分具有相关性(P<0.05)。精神焦虑评分与主观睡眠质量、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、日间功能障碍评分均具有明显相关性(P<0.01)。结论脑梗死并发睡眠呼吸障碍患者存在较为明显的焦虑情绪,其睡眠质量较差,焦虑与睡眠质量密切相关。

Objective To investigate the anxiety and its effect on the sleep quality in patients with cerebral infarction and sleep-disordered breathing.Methods 149 cerebral infarction patients were divided as 95 without sleep-disordered breathing and 54 with sleep-disordered breathing.They were evaluated with Hamilton Anxiety scale （HAMA） and Pittsburgh Sleep Quality Index （PSQI）.Results Patients with sleep-disordered breathing showed higher HAMA overall score and factor scores of somatic anxiety and psychic anxiety（P0.001）.In the factors of somatic anxiety,the scores of sensing,cardiovascular,gastrointestinal and autonomic nerve system were higher in patients with sleep-disordered breathing than those without sleep-disordered breathing （P0.05）.In the factors of psychic anxiety,the scores of anxious mood,tension,fears,insomnia,depressed mood were higher in patients with sleep-disordered breathing（P0.05）.PSQI overall score and all factor scores were also higher in patients with sleep-disordered breathing（P0.001）.HAMA overall score as well as psychic anxiety and somatic anxiety scores were closely correlated with the PSQI overall score （P0.001）.Somatic anxiety score was correlated with subjective sleep quality,sleep latency,sleep disturbance and daily dysfunction scores （P0.05）.Psychic anxiety score was correlated with all the dimension scores of PSQI （P0.01）.Conclusion Cerebral infarction patients with sleep-disordered breathing appeared anxiety and worse sleep quality than patients without sleep-disordered breathing.Anxiety is closely related with sleep quality.