不同类型脑梗死患者睡眠结构及其与抑郁的相关性研究

Structure and correlation of different types of sleep in patients with cerebral infarction and depression

目的分析研究不同类型脑梗死患者睡眠结构及其与抑郁的相关性,为脑梗死患者睡眠障碍及抑郁的治疗提供新的思路及理论支持。方法抽取我院2012年4月—2015年5月接收的124例脑梗死患者进行分组研究,根据脑梗死不同发生部位将患者分为四组,分别为小脑梗死组30例、皮层梗死组33例、脑干梗死组29例及皮层下梗死组32例,对比观察四组患者睡眠结构及睡眠参数和睡眠障碍、HAMD评分的相关性。结果四组患者睡眠结构相比存在明显差异,脑干梗死组和皮层下梗死组觉醒时间远多于小脑梗死组和皮层梗死组,小脑梗死组NREM 1+2期、NREM期明显短于皮层梗死组、脑干梗死组及皮层下梗死组,小脑梗死组REM期、NREM 3+4期明显大于皮层梗死组、脑干梗死组及皮层下梗死组,各项数据对比差异均有统计学意义(P<0.05);HAMD评分、PSQI评分和NREM1+2期、觉醒指数呈正相关关系(P<0.05,r>0);与REM期和NREM 3+4期呈负相关关系(P<0.05,r<0)。结论皮层下梗死睡眠结构紊乱发生率更高,并且睡眠结构的变化和脑梗死后抑郁评分、睡眠障碍评分具有一定关系。

Objective To study the correlation between sleep structure and depression in patients with different types of cerebral infarction, to provide new ideas and theoretical support for the treatment of sleep disorders and depression in patients with cerebral infarction. Methods 124 patients with cerebral infarction in our hospital from April 2012 to May 2015 were selected. They were divided into four groups according to the different parts of the cerebral infarction, respectively, 30 cases of cerebellar infarction group, 33 cases of cortical infarction group, 29 cases of brainstem infarction group and 32 cases of subcortical infarction group. The correlation of sleep structure and sleep parameters, sleep disorder and HAMD score of the four groups were observed and compared. Results There was a significant difference in sleep structure between the four groups. Brainstem infarction group and subcortical infarction group awakening time was far more than that of cerebellar infarc- tion group and cortex infarction group. Cerebellar infarction group NREM 1 ＋ 2, NREM period was significantly shorter in cortical infarction, brain stem infarction group and subcortical infarction group. Cerebellar infarction group of REM and NREM stage 3 ＋ 4 were significantly greater than that of cortical infarction death group, brain stem infarction group and cerebral cortex infarction group. The differences were statistically significant （ P 〈 0. 05 ） ; HAMD score, PSQI score and NREM1 ＋ 2 period, arousal index was positively correlated （P 〈 0. 05, r 〉 0） ; And REM phase and 3 ＋ 4 NREM phase was negatively correlated （P 〈 0. 05, r 〈 0）. Conclusion Subcortical infarction sleep structure disorder incidence is higher, and the sleep structure changes and infarction depression score, sleep disorder score has a certain relationship.