失眠可增加卒中患者死亡风险:一项对首次卒中发作患者的6年随访研究

Stroke ＆ Vascular Neurology杂志近期发表了一篇题为＂Insomnia is associated with increased mortality in patients with Chinese cohort study＂的文章,该研究由首都医科大学附属北京天坛医院神经精神医学科/行为神经病学与睡眠中心王春雪主任团队成员共同参与完成。

Persistent depression is a predictor of quality of life in stroke survivors: results from a 5-year follow-up study of a Chinese cohort

Background:Whether the time course of post-stroke depression (PSD) can be used to predict the quality of life (QoL) of patients with late-stage stroke remains unclear,this study investigated whether persistent depression at 1 year after stroke predicts QoL at 5 years following stroke.Methods:We analyzed the demographic and clinical data of patients with stroke in 56 hospitals across China that participated in the Prospective Cohort Study on the Incidence and Outcome of Patients with PSD in China Study.Follow-up assessments were performed at the following time points after stroke:in person,2 weeks,3 months,6 months,and 1 year;by telephone,5 years.National Institutes of Health Stroke Scale (NIHSS) score on admission,recurrence,disability,depression,QoL,and chronic complications were recorded.Depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders.QoL was measured using short form-12 (SF-12).Multivariable ordinal logistic regression analysis was used to identify factors that independently affected the physical component summary (PCS) and mental component summary (MCS) scores of the SF-12.Results:Of the 801 patients evaluated in this study,80 had persistent depression.The multivariable regression analysis of data obtained at 5 years showed that persistent depression at 1 year (odds ratio [OR]:0.48;95% confidence interval [CI]:0.29-0.81) and disability at 5 years (OR:0.34;95% CI:0.23-0.49) were associated with poor MCS scores at 5 years.Old age,a high NIHSS score on admission,disability at 5 years,and stroke recurrence within 5 years were associated with poor PCS scores at the 5-year follow-up.Conclusions:Persistent depression at the 1-year follow-up could predict poor MCS scores at the 5-year follow-up.The development of interventional strategies targeting post-stroke patients with persistent depression is warranted.

Insomnia is associated with increased mortality in patients with first-ever stroke:a 6-year follow-up in a Chinese cohort study

Objective Insomnia is a highly prevalent disorder among patients suffering from stroke.The association between insomnia and stroke mortality is less studied,particularly using the latest diagnostic criteria.The current study examined the relationship between insomnia and mortality among patients with first-evonal hazard models were used to calculate HRs for stroke er stroke in China.Methods Patients with acute cerebrovascular diseases(stroke)were recruited from 56 hospitals in China's Mainland.Insomnia was defined as difficulty falling asleep,or difficulty staying asleep or waking up early,for at least two consecutive visits.Demographic data,medical history and clinical data were collected.Four follow-up visits occurred within the first year after stroke,and the last follow-up call was conducted 6 years later.Cox proportional hazard models were used to calculate HRs for stroke mortality.results Insomnia was reported by 38.4%(489/1273)of patients at baseline.During the 6 years of follow-up,after adjusting for all confounders,insomnia was found to be associated with increased mortality(HR=1.66,95%CI 1.10 to 2.48).Old age(HR=1.08,95%CI 1.06 to 1.10),stroke recurrence in the first year of follow-up(HR=2.53,95%CI 1.48 to 4.31)and stroke survivors with hypertension(HR=1.62,95%CI 1.04 to 2.53)had substantially higher risk of mortality.Conclusions Besides old age,stroke recurrence in the first year of follow-up and hypertension,insomnia is associated with increased risk of mortality in patients with first-ever stroke in China.More studies about prompt and efficient interventions for insomnia are expected in the future.Trial registration number rctn62169508.