摘要
目的探讨甲状腺功能谱与急性缺血性卒中患者早期新发失眠的相关性。方法该研究为纵向观察性的队列研究,前瞻性连续纳入2018年5月至2019年5月南京医科大学附属金陵医院神经内科住院的急性缺血性卒中患者276例。根据国际睡眠障碍分类第三版(ICSD-3)失眠的诊断标准,将卒中患者分为失眠组(64例)和非失眠组(212例)。采用单因素分析及多因素Logistic回归分析依次探讨甲状腺功能谱与卒中早期新发失眠之间的相关性,以及促甲状腺激素(TSH)水平正常亚组患者中失眠组与非失眠组TSH水平的差异。结果纳入的276例急性缺血性卒中患者中,失眠组64例(23.2%),非失眠组212例(76.8%)。与非失眠组比较,失眠组血清TSH水平较高[1.9(1.0,3.7)mU/L比1.6(1.0,2.4)mU/L,P=0.044]。多因素Logistic回归分析调整混杂因素后,显示血清中较高的TSH水平是急性缺血性卒中患者早期新发失眠的独立危险因素(OR=1.214,95%CI:1.016~1.449,P=0.032)。在TSH正常亚组中,失眠组的血清TSH水平较非失眠组高[1.8(1.1,2.8)mU/L比1.6(1.1,2.3)mU/L],多因素Logistic回归分析结果显示,相对较高的血清TSH水平是早期新发失眠的独立危险因素(OR=1.635,95%CI:1.047~2.554,P=0.031)。结论血清TSH与急性缺血性卒中早期新发失眠相关,提示甲状腺功能轴可能在急性缺血性卒中早期新发失眠中发挥作用。
Objective To explore the correlation between thyroid function profiles and early onset of insomnia in patients with acute ischemic stroke.Methods This longitudinal observational cohort study prospectively enrolled 276 acute ischemic stroke patients admitted to the Department of Neurology,Jinling Hospital,Nanjing Medical University from May 2018 to May 2019.According to the diagnostic criteria for insomnia in international classification of sleep disorders,3rd edition (ICSD-3),stroke patients were divided into insomnia group (64 patients) and non-insomnia group (212 patients).Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlation between thyroid function profiles and early onset insomnia in early stroke and the difference of TSH levels between insomnia group and non- insomnia group in subgroup of patients with normal TSH.Results A total of 276 patients with acute ischemic stroke were included in the study.There were 64 patients (23.2%) in the insomnia group and 212 patients (76.8%) in the non-insomnia group.Serum TSH levels were higher in the insomnia group compared with the non-insomnia group (1.9 [1.0,3.7]mU/L vs.1.6[1.0,2.4] mU/L,P =0.044).After adjusting for confounding factors by multivariate Logistic regression analysis,the results show that higher TSH level in serum was an independent risk factor for early new insomnia in patients with acute ischemic stroke ( OR,1.214,95% CI 1.016 - 1.449,P =0.032).In addition,in the subgroup with normal TSH,serum TSH levels in the insomnia group were still higher than those in the non-insomnia group(1.8[1.1,2.8] mU/L vs.1.6[1.1,2.3] mU/L),and the multivariate regression analysis showed that the relatively high TSH level was an independent of risk factor for early insomnia ( OR,1.635,95%CI 1.047 - 2.554,P = 0.031).Conclusion Serum TSH is associated with early onset insomnia in acute ischemic stroke,suggesting that the thyroid function axis may play a role in new insomnia in early stroke.
作者
刘玉景
彭敏
刘远路
谷蒙蒙
肖露露
黄显军
孙文
刘新峰
Liu Yujing;Peng Min;Liu Yuanlu;Gu Mengmeng;Xiao Lulu;Huang Xianjun;Sun Wen;Liu Xinfeng(Department of Neurology,Jinling Hospital,Nanjing Medical University,Nanjing 210000,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2019年第10期526-532,共7页
Chinese Journal of Cerebrovascular Diseases
关键词
甲状腺功能谱
失眠
急性缺血性卒中
Thyroid function profiles
Insomnia
Acute ischemic stroke
