影响急性脑梗死患者睡眠质量的相关因素

目的 评价急性脑梗死患者睡眠质量,探讨影响急性脑梗死患者睡眠质量的危险因素,为临床诊断和防治提供依据.方法 以华北煤炭医学院附属医院神经内科2006年10月至2008年3月住院有睡眠障碍的急性脑梗死患者96例为病例组,病程在2周以内,且均为首发脑梗死.采用匹兹堡睡眠质量指数(PSQI)量表进行调查.对照组为同期住院无睡眠障碍的急性脑梗死患者145例.对影响急性脑梗死患者睡眠质量的危险因素进行分析.结果 急性脑梗死患者的睡眠障碍与病变部位有关,以皮质下组发生睡眠障碍的危险性高.患者的睡眠障碍与病情也有关,睡眠障碍随病情加重而加重(中、重度与轻度比较,OR值分别为2.22、7.25,χ~2=21.35,P=0.0000);日常生活能力越差,发生睡眠障碍的危险性越高;文化程度越高,发生睡眠障碍的危险性越高(小学、中学、大专及以上文化程度与文盲比较,OR值分别为1.08、1.98、6.50,χ~2=19.61,P=0.0002);随着抑郁程度的加重,睡眠障碍逐渐加重;体力劳动者睡眠障碍发病风险低于脑力劳动者(OR 0.31,χ~2=17.83,P=0.0000).结论 高文化程度、发生在皮质下部位的脑梗死、病情重、抑郁是急性腩梗死患者睡眠障碍的危险因素,体力劳动者睡眠障碍的发病危险性低.

The study of risk factors on sleep quality in acute cerebral infarction patients

Objective To evaluate the quality of sleep in acute cerebral infarction patients,to discuss risk factors of reduced such quality,and to improve clinical diagnosis,prevention and cure.Methods Totally 96 patients with acute cerebral infarction admitted from Oct 2006 to Mar 2008 in the neurological department of North China Coal Medical University were retrospectively reviewed as case group in this study.Sleep quality assessment was performed by using Pittsburgh Sleep Quality Index(PSQI).All 145 patients without sleep disorders at the above same period of time were studied as the control group.Risk factors effecting sleep quality in acute stroke patients were analyzed.Results Sleep disolders in acute cerebral infarction patients were related with local damage,subcortex group being higher than others.Sleep dysfunction in acute cerebral infarction patients was related to severity of stroke.The symptom of sleep disorders was severer with the stroke condition getting worse(OR 2.22,7.25,χ~2=21.35,P=0.0000).The risk of sleep disorders wag increased with the capability of daily activities getting worse(OR 0.79,1.65,3.91,χ~2=18.36,P=0.001).The risk of sleep disorders was increased with the education level higher (OR 1.08,1.98,6.50,χ~2=19.61,P=0.0002).The symptom of sleep disorders was severer with the depression getting worse(OR 8.19,9.91,14.44,χ~2=15.98,P=0.0000).The risk of sleep disolders was lower in acute cerebral infarction patients with occupations as manual labour than those as professional(OR 0.31,χ~2=17.83,P=0.0000).Conclusions The higher education level,the subcortex of cerebral infarction,the Worse of clinical condition and depression were risk factors of sleep disorders in acute cerebral infarction patients and manual labor has lower risk.