脑卒中患者精神疲劳的影响因素分析

Influencing factors of mental fatigue in patients with stroke

目的了解脑卒中患者精神疲劳的影响因素。方法采用以医院为基础的非配比病例对照研究的方法,选取唐山市工人医院神经内科住院的脑卒中患者358例,其中疲劳组175例(MFS评分≥10.5分)和非疲劳组183例(MFS评分<10.5分),采用精神疲劳自评量表(MFS)、简易智力检查量表(MMSE)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、自制一般状况量表进行问卷调查。结果疲劳组的MFS总分及各维度得分均高于非疲劳组,总分[(17.68±5.06)分和(5.70±2.15)分],疲劳感知[(6.86±2.17)分和(2.12±1.15)分],认知疲倦[(3.58±1.54)分和(1.12±0.93)分],敏感性增加[(5.90±2.05)分和(1.95±1.20)分],睡眠改变[(1.35±0.82)分和(0.51±0.62)分];多因素Logistic回归分析显示:收入<支出(β=0.608,OR=1.836,95%CI=1.037~3.252)、有认知功能障碍(β=1.886,OR=6.594,95%CI=3.276~13.275)、轻度焦虑(β=0.770,OR=2.160,95%CI=1.069~4.364)、中度焦虑(β=1.157,OR=3.181,95%CI=1.230~8.228)、重度焦虑(β=1.295,OR=3.651,95%CI=1.096~12.160)、中度与重度抑郁(β=1.318,OR=3.738,95%CI=1.318~10.602)是脑卒中患者精神疲劳的主要影响因素。结论收入<支出、认知功能障碍、焦虑和中、重度抑郁是脑卒中患者发生精神疲劳的危险因素。

Objective To investigate the influencing factors of mental fatigue in patients with cerebral apoplexy.Methods Using a hospital-based case-control method,total 358 patients with cerebral apoplexy from Tangshan Gong Ren Hospital were recruited from October 2016 to May 2017.A total of 175 subjects were fatigue group(MFS≥10.5),the remaining 183 individuals were non-fatigue group(MFS<10.5).All the patients with stroke were investigated with MFS,MMSE,SAS,SDS and homemade general scale.Results The total MFS score(17.68±5.06)vs(5.70±2.15)and dimensions score of fatigue perception(6.86±2.17)vs(2.12±1.15),cognition fatigue(3.58±1.54)vs(1.12±0.93),increased sensitivity(5.90±2.05)vs(1.95±1.20),changes of sleep(1.35±0.82)vs(0.51±0.62)in the fatigue group were higher than those of the non-fatigue group,total score.Multivariate Logistic regression showed that income below expenditure(β=0.608,OR=1.836,95%CI=1.037-3.252),cognitive dysfunction(β=1.886,OR=6.594,95%CI=3.276-13.275),mild anxiety(β=0.770,OR=2.160,95%CI=1.069-4.364),moderate anxiety(β=1.157,OR=3.181,95%CI=1.230-8.228),severe anxiety(β=1.295,OR=3.651,95%CI=1.096-12.160),moderate and severe depression(β=1.318,OR=3.738,95%CI=1.318-10.602)were the influencing factors of mental fatigue in stroke patients.Conclusion Income below expenditure,cognitive dysfunction,mild anxiety,moderate anxiety,severe anxiety,moderate and severe depression are the potential risk factors of mental fatigue in stroke patients.