无躯体症状性脑梗死患者并发睡眠障碍有关因素的横断面研究

A cross-sectional study on the related factors of sleep disorders in patients with silent cerebral infarction

目的探讨无躯体症状性脑梗死(SCI)患者并发睡眠障碍的有关因素。方法选择南京医科大学附属脑科医院2021年8月至2022年9月SCI患者126例,依据1年随访情况分为并发睡眠障碍组、对照组。收集两组临床资料,确定SCI患者并发睡眠障碍的独立影响因素,判定各独立影响因素的预测价值。结果126例患者1年随访显示,并发睡眠障碍37例(29.37%)。两组年龄、高血压、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、日常生活能力量表(ADL)评分比较,差异有统计学意义(~均P<0.05)。多因素Logistic回归分析显示,年龄、HAMD、HAMA、ADL评分均为SCI患者并发睡眠障碍独立危险因素(OR分别为1.159、1.307、1.526、1.141)(~均P<0.05)。绘制受试者工作特征(ROC)曲线显示,各独立影响因素(年龄、HAMD、HAMA、ADL评分)均对SCI患者并发睡眠障碍具有一定预测价值,曲线下面积(AUC)分别为0.684、0.685、0.688、0.652(~均P<0.05)。结论SCI患者并发睡眠障碍发生率高,相关因素包括年龄、抑郁、焦虑及日常生活能力,改善患者心理状态及日常生活能力可能是降低睡眠障碍发生率的重要途径。

Objective To investigate the related factors of sleep disorders in patients with silent cerebral infarction(SCI).Methods A total of 126 patients with SCI in our hospital from August 2021 to September 2022 were selected and divided into sleep disorders group and control group according to 1-year follow-up.The clinical data of the two groups were collected to determine the independent influencing factors of sleep disorders in SCI patients,and to determine the predictive value of each independent influencing factor.Results One-year follow-up of 126patients with SCI showed that 37 cases(29.37%)had sleep disorders.There were statistically significant differences in age,hypertension,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and Activity of Daily Living Scale(ADL)scores between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age,HAMD,HAMA and ADL scores were independent risk factors for sleep disorders in SCI patients(OR=1.159,1.307,1.526,1.141,respectively)(P<0.05).The receiver operating characteristic(ROC)curve showed that each independent influencing factor(age,HAMD,HAMA,ADL score)had certain predictive value for sleep disorders in SCI patients,and the area under the curve(AUC)was 0.684,0.685,0.688 and 0.652,respectively(P<0.05).Conclusion The incidence of sleep disorders in SBI patients is high,and the related factors include age,depression,anxiety and daily living ability.Improving the psychological state and daily living ability of patients may be an important way to reduce the incidence of sleep disorders.