既往睡眠障碍对急性轻型脑卒中的影响研究

The Effects of Previous Sleep Disorders on Acute Light Stroke

目的 分析急性轻型脑卒中患者既往睡眠障碍的特点、影响因素,及与卒中后神经功能缺损及日常生活能力的相关关系.方法 该研究共纳入267例急性轻型脑卒中患者,采用匹兹堡睡眠质量指数量表（Pittsburgh Sleep Quality Index,PSQI）、综合医院焦虑抑郁量表（Hospital Anxiety and Depression Scale,HADS）评价卒中患者既往睡眠障碍及焦虑抑郁程度,采用Barthel指标（Barthel Index,BI）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）评价卒中后日常生活能力及神经功能缺损.分析急性轻型脑卒中患者既往睡眠障碍的发生特点及影响因素并比较轻型脑卒中既往睡眠障碍者与既往无睡眠障碍者卒中后BI评分及NIHSS评分的差异.结果 （1）31.5%的轻型脑卒中患者既往存在睡眠障碍,其中,睡眠障碍的主要类型为入睡时间延长,早醒及夜间维持睡眠困难及日间思睡;（2）轻型脑卒中患者既往睡眠障碍的发生率与合并慢性病种类及抑郁情绪有关;（3）既往睡眠障碍者其卒中后BI评分显著低于无睡眠障碍者,NIHSS评分显著高于无睡眠障碍者,差异有统计学意义（P〈0.05）.结论 睡眠障碍是急性轻型脑卒中发生的高危因素,尤其是自身合并较多慢性病种类及抑郁情绪的患者,同时既往睡眠障碍与卒中后神经功能缺损及日常生活能力密切相关.

Objective To analyze the characteristics and influence factors of sleep disorders in acute light stroke and correlation between the previous sleep disorders and nerve function defect and daily life ability. Methods This study included 267 patients with initial and light stroke. We evaluate the extent of sleep disorders and Pittsburgh Sleep Quality Index （PSQI） and Hospital Anxiety and Depression Scale （HADS） and nerve function defect and daily life ability by Barthel Index （BI） and National Institutes of Health Stroke Scale （NIHSS）. This paper analyzes the characteristics and influences of the sleep disorders in light stroke and differences in BI scores and NIHSS scores were compared after stroke between previous sleep disorder group and no sleep disorder group. Results （1）31.5% of the patients with light stroke had previous sleep disorders, among whom the main type of sleep disturbance is prolonged sleep time, early wake and night maintenance sleep difficulties and daytime sleep; （2）The incidence of sleep disorders in patients with light stroke was associated with the combination of the types of chronic diseases and depression; （3）BI scores were significantly lower than those with no sleep disorder and NIHSS scores were significantly higher than those with no sleep disorder after stroke, the difference was statistically significant （P〈0.05）. Conclusion Sleep disorders are a high risk factor for light stroke, in particular, patients with a greater variety of chronic diseases and anxiety and depression in themselves. At the same time, sleep disorder is closely related to post-stroke nerve function defect and daily life ability.