睡眠障碍与脑卒中患者抑郁的相关性研究

目的 探讨睡眠障碍与脑卒中患者抑郁的相关性。方法 选取2016 年1 月—2017 年12 月于安 徽医科大学附属巢湖医院收治的138 例初发脑卒中康复期患者作为研究对象，采用抑郁自评量表（SDS）、匹 兹堡睡眠量表指数量表（PSQI）分别评价脑卒中患者的抑郁状况和睡眠质量，根据SDS 评分诊断患者脑卒 中后抑郁（PSD），分析睡眠障碍与PSD 的关系，采用多因素Logistic 回归探讨PSD 发生的影响因素，采用 Pearson 相关性分析探讨患者SDS 与PSQI 评分的关系。结果 离异或丧偶、伴有糖尿病史、出血性脑卒中、 脑卒中位于皮质下、左半球、无定期进行康复锻炼、自理能力明显障碍、有睡眠障碍患者的发生PSD 发生率 均有升高（P <0.05）。多因素Logistic 回归结果表明婚姻状况Ol ^ R=2.517，（95 CI ：1.133，5.594），P =0.023]、 脑卒中类型Ol ^ R=1.126，（95 CI ：1.005，1.262），P =0.041]、康复锻炼状况Ol ^ R=1.283，（95 CI ：1.024， 1.607），P =0.030]、自理能力明显障碍Ol ^ R=2.942，（95 CI：1.291，6.707），P =0.010]、睡眠障碍Ol ^ R=1.585，（95 CI ：1.105,2.273），P =0.012] 是患者发生PSD 的关键的独立危险因素。SDS 评分与主观睡眠障碍、睡眠效率、 睡眠障碍及日间功能障碍均呈正相关（r =0.303、0.178、0.269 和0.208，P =0.000、0.037、0.001 和0.014）。 SDS 评分与主观睡眠障碍、睡眠效率、睡眠障碍及日间功能障碍均呈正相关（r =0.303、0.178、0.269 和 0.208，P <0.05）。结论 脑卒中康复期患者容易发生睡眠障碍，睡眠障碍与PSD 发生具有一定的相关性，且 睡眠质量越差，抑郁表现越严重。

Relationship of sleep disturbance and depression in patients with stroke

Objective To explore the relationship of sleep disturbance and depression in patients with stroke. Methods Totally 138 convalescent patients with primary stroke from January 2016 to December 2017 were enrolled the study. Hamilton Depression Scale (SDS) and Pittsburgh sleep quality index (PSQI) were performed to evaluate the depression and sleep quality, and post-stroke depression (PSD) was diagnosed by the SDS score. The relationship between sleep disturbance and PSD was analyzed. Multivariate logistic regression analysis was performed to investigate the related factors of PSD. Pearson correlation analysis was used to investigate the relationship between the score of SDS and PSQI. Results PSD incidence rate of patients divorced or widowed and with a history of diabetes, hemorrhagic stroke, stroke in the subcortical, left hemisphere, no regular rehabilitation exercise, significant self-care disability and sleep disorders is increased (P < 0.05). Multivariate logistic regression results showed that marital status Ol ^ R=2.517, (95 CI: 1.133, 5.594), P =0.023], types of stroke Ol ^ R=1.126, (95 CI: 1.005, 1.262), P =0.041], rehabilitation exercise statusOl ^ R=1.283, (95 CI: 1.024, 1.607), P =0.030], significant selfcare disability Ol ^ R=2.942, (95 CI: 1.291, 6.707), P =0.010] and sleep disorders Ol ^ R=1.585, (95 CI: 1.105, 2.273),P =0.012] were the key independent risk factors for PSD (P < 0.05). The SDS scores of all patients were positively correlated with the scores of PSQI subjective sleep disorder, sleep efficiency, sleep disturbance, and daytime dysfunction (P < 0.05). Conclusions Sleep disorders are prone to occur in stroke patients during rehabilitation period. Sleep disorders are correlated with PSD. The worse the quality of sleep, the worse the depression.