急性缺血性卒中患者失眠的危险因素分析

Analysis of risk factors of insomnia in patients with acute ischemic stroke

目的分析急性缺血性脑卒中患者出现卒中后失眠的危险因素,以期为早期预防及治疗卒中后失眠提供一定的临床依据。方法回顾性分析2015年1月—2018年9月住院的127例急性缺血性脑卒中患者的临床资料。参考发病2周内病情稳定、排除谵妄等情况进行汉密尔顿抑郁量表(HAMD)及北京版蒙特利尔认知评估(MoCA)量表测评,根据有无失眠,分为卒中后失眠组与卒中后无失眠组,通过统计学分析探讨急性缺血性脑卒中患者出现卒中后失眠的危险因素。结果与卒中后无失眠组比较,卒中后失眠组美国国立卫生研究院卒中量表(NIHSS)评分较高、HAMD评分较高(P=0.032,P<0.001);2组间病灶位置有差异。结论NIHSS评分高、HAMD评分高及病灶位置不同是急性缺血性脑卒中患者出现失眠的危险因素。临床工作中在对卒中患者积极治疗的同时,应重视睡眠问题,早期干预与治疗,可能会降低卒中复发风险、改善中风后的功能结局。

Objective To analyze the risk factors of post-stroke insomnia in patients with acute ischemic stroke in order to provide certain clinical basis for the early prevention and treatment of post-stroke insomnia.Methods The clinical data of 127 patients with acute ischemic stroke who were hospitalized from January 2015 to September 2018 were retrospectively analyzed.National Institutes of Health Stroke Scale(NIHSS)score,Hamilton Depression Scale(HAMD)score and Beijing version of Montreal Cognitive Assessment(MoCA)score of the patients were assessed according to the patient's condition stability and delirium elimination within 2 weeks of onset.According to whether there was insomnia,the patients were divided into the post-stroke insomnia group and the post-stroke non-insomnia group.The risk factors of post-stroke insomnia in patients with acute ischemic stroke were investigated by statistical analysis.Results Compared with the post-stroke non-insomnia group,NIHSS score and HAMD score were higher in the post-stroke insomnia group(P=0.032,P<0.001).There was the difference in the lesion location between the two groups.Conclusion High NIHSS score,high HAMD score and different focus locations are risk factors for poststroke insomnia in patients with acute ischemic stroke.In clinical work,when the stroke patients are actively treated,attention should be paid to their sleep problems at the same time.Early intervention and treatment may reduce the risk of stroke recurrence and improve the functional outcome of patients after stroke.