睡眠时长与不同缺血性卒中亚型的相关性

目的  探讨睡眠时长与不同缺血性卒中(ischemic stroke，IS)亚型的相关性。 方法  以北京市农村社区居民为研究对象，开展问卷调查、体格检查以及血生化检测。睡眠时长作为分类变量，分为睡眠时长≤ 5 h/d(< 5.5 h/d)、6 h/d(5.5~6.5 h/d)、7 h/d(6.5~7.5 h/d)、8 h/d(7.5~8.5 h/d)、≥ 9 h/d(≥ 8.5 h/d)，依据急性卒中Org 10172治疗试验(trial of org 10172 in acute stroke treatment，TOAST)分型对IS进行分型，采用Logistic回归分析模型睡眠时长与不同IS亚型的相关性。 结果  共纳入6 370名研究对象，平均年龄为(58.34±9.37)岁。Logistic回归分析模型显示，在调整年龄、性别、行为生活方式、社会经济状况和健康状态后，与睡眠时长为7 h/d的相比，睡眠时长≤ 5 h/d的患IS、大动脉粥样硬化型卒中，小动脉闭塞型卒中和不明原因型卒中的风险分别是对照组的1.75倍(95%CI：1.42~2.15，P < 0.001)、1.98倍(95%CI：1.46~2.70，P < 0.001)、5.73倍(95%CI：3.34~9.83，P < 0.001)和4.43倍(95%CI：1.86~10.53，P=0.001)。然而，睡眠时长8 h/d和≥ 9 h/d仅在IS和大动脉粥样硬化型卒中中表现出有统计学意义(P < 0.05)。 结论  睡眠不足与IS、大动脉粥样硬化型卒中、小动脉闭塞型卒中和不明原因型卒中风险增加有关，而睡眠过长仅与IS和大动脉粥样硬化型卒中风险增加有关。

Associations between sleep duration and different ischemic stroke subtypes

  Objective  To explore the relationship between sleep duration and different ischemic stroke (IS) subtypes.  Methods  Participants in the study were recruited from rural communities in Beijing. The survey questionnaires, physical examination and biochemical tests were performed. Sleep duration was categorized into 5 groups, namely ≤ 5 hours/day, 6 hours/day (5.5-6.5 h/d), 7 hours/day (6.5-7.5 h/d), 8 hours/day (7.5-8.5 h/d) and ≥ 9 hours/day(≥ 8.5 h/d). Classification of ischemic stroke was based on Trial of org 10172 in acute stroke treatment(TOAST)classification. Logistic models were used to evaluate the associations between sleep duration and different IS subtypes.  Results  A total of 6 370 participants were recruited. The average age was (58.34±9.37) years old. Logistic regression analysis showed that after adjusting for age, sex, behavioral lifestyle, socioeconomic status and health status, compared to subjects with 7 hours/day, subjects with sleep duration ≤ 5 hours/day was significantly associated with increased risk of IS (OR=1.75, 95% CI: 1.42-2.15, P < 0.001), large-artery atherosclerosis (OR=1.98, 95% CI: 1.46-2.70, P < 0.001), small-artery occlusion lacunar (OR=5.73, 95% CI: 3.34-9.83, P < 0.001) and stroke of undetermined etiology (OR=4.43, 95% CI: 1.86-10.53, P=0.001). Subjects with sleep duration 8 hours/day and ≥ 9 hours/day was only found to be significantly associated with IS and large-artery atherosclerosis (P < 0.05).  Conclusions  Short sleep duration is associated with increased risk of IS, large-artery atherosclerosis, small-artery occlusion lacunar and stroke of undetermined etiology. But long sleep duration is only associated with increased risk of IS and large-artery atherosclerosis.