初发脑梗死后失眠患病率及相关因素分析

The prevalance and influential factors of insomnia after the first ever ischemic stroke

目的:探讨初发脑梗死后失眠的发病情况及相关影响因素。方法:纳入脑梗死患者150例,采用匹兹堡睡眠质量指数(PSQI)、改良Barthel指数(MBI)、神经功能缺损程度评分(NDS)、汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)进行测评,并以PSQI量表总分>7分作为判断失眠的标准。分析卒中患者失眠的类型及特点;分析失眠在不同类型人群中发生率的差异,筛选影响因素;分析失眠患者与非失眠患者各量表评分的差异。结果:150例患者中,73例(48.67%)发生失眠,失眠的形式以入睡困难、早醒、睡眠维持困难为主。失眠的发生率与性别、卒中部位、临床神经功能缺损程度、日常生活能力、精神状态关系密切。失眠患者在神经功能缺损程度、焦虑和抑郁程度方面较非失眠患者严重(P<0.05),日常生活能力较低(P<0.05)。结论:初发缺血性脑卒中患者失眠的发生率较高,影响因素有性别、卒中的部位、生活能力、神经功能缺损程度及精神状态。

Objective： To explore the clinical features and influential factors for the insomnia in patients with first ever ischemic stroke. Methods： One hundred and fifty patients with stroke were recruited. Pittsburgh Sleep Quality Index（ PSQI）,Nerve Function Deficit Score（ NDS）,Modified Barthel Index（ MBI）,Hamilton Depression Scale（ HAMD） and Hamilton Anxiety Scale（ HAMA） were used to evaluate insomnia of the enrolled patients. Insomnia was defined as PSQI scores were higher than 7. The types and features of insomnia in poststroke patients were reviewed. Influential factors were differentially analyzed respect to the incidence of insomnia among different populations with stroke. The differences of scores evaluated by each scale were compared between patients with or without insomnia. Results： Insomnia,which occurred in 73 out of 150 patients（ 48. 67%）,featured as difficulty sleeping,wake up early,sleep maintenance difficulties. The incidence of insomnia in the patients with stroke was closely associated with gender,stroke location,neurologic impairment,activity of daily living and mental status. Severer neurologic impairment and depression and lower activity of daily living were found in the patients with insomnia compared to those without insomnia（ P〈0. 05）. Conclusion： The incidence of insomnia is higher in patients with first ever ischemic stroke. The main factors influencing the incidence are gender,stroke site,extent of neurologic impairment,activity of daily living and mental status.