急性脑卒中患者睡眠障碍的异质性研究

Clinical heterogeneity of insomnia disorder for acute stroke patients

目的探讨急性脑卒中患者睡眠障碍的临床异质性。方法采用匹兹堡睡眠质量指数量表(PSQI)对168例急性脑卒中患者与98例正常对照者的睡眠状况进行测评分析,同时采用Barthel指数(BI)与美国国立卫生研究院卒中量表(NIHSS)分别评价脑卒中患者的日常生活活动能力与神经功能缺损程度。结果脑卒中组睡眠障碍发生率(45.83%)明显高于对照组(16.32%%)(P<0.001);脑卒中组PSQI总分以及睡眠质量、入睡时间、睡眠障碍、催眠药物、日间功能障碍五因子得分均明显高于对照组(P<0.05):年龄<50岁脑卒中组PSQI总分明显高于其它年龄组;脑卒中患者睡眠障碍的发生与年龄、性别、Barthel指数及神经功能缺损程度有关。结论急性脑卒中患者存在显著的睡眠障碍,年龄<50岁伴神经功能缺损的女性脑卒中患者更明显,而且不同脑卒中患者PSQI各因子方面存在明显的临床异质性。

Objective To investigate the clinical heterogeneity of insomnia disorder in acute stroke pa-tients.Methods A hunred and sixty-eight patients with acute stroke and 98 healthy people were enrolled in this study.Pittsburgh Sleep Quality Index（PSQI）were used to evaluate status of sleep from the selected pa-tients and healthy group,Barthel Index（BI）for the activities of daily living,and NIH Stroke Scale（NIHSS）for the degree of neuro-function impairment.Results The incidence of insomnia in stroke patients wag 45.83%, significantly higher than that （16.32%）in healthy group （P 〈0.001 ）.Also,stroke patients scored higher in PSQI total score and 5 subset of 7 in PSQI---overall sleep quality,sleep latency,sleep disturbance,need meds to sleep,and day dysfunction due to sleepiness,compared to healthy group （P 〈0.05）.The age,gender,Barthel Index,and NIHSS were correlated with the occurrence of insomnia.Conclusions The incidence of insomnia in acute stroke patients is relatively hish,especially in the subgroup of the female of age〈50 years with comprised neuro-function.And there is significant clinic heterogeneity in PSQI for acute stroke patients.