摘要
目的探讨急性缺血性卒中(AIS)后睡眠障碍与预后的关系,并分析影响预后的其他危险因素。方法选取2019年12月至2020年12月该院收治的AIS患者106例作为观察组,其中预后良好[改良RANKIN量表(mRS)评分0~2分]46例(预后良好组),预后不良[mRS评分3~6分]60例(预后不良组);选取同期健康体检者103例作为对照组。采用匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)、STOP-Bang问卷(SBQ)评估两组研究对象睡眠情况,分析PSQI、ESS、SBQ评分与预后的相关性。收集观察组患者的临床资料,分析卒中相关危险因素与预后的关系。结果观察组患者PSQI、ESS评分均明显高于对照组,预后不良组患者PSQI、ESS、SBQ评分均明显高于预后良好组,差异均有统计学意义(P<0.05)。PSQI评分与预后不良呈正相关(r=0.251,P<0.05)。年龄、纤维蛋白原水平、血糖水平、美国国立卫生研究院卒中量表(NIHSS)评分、发病至溶栓时间(ONT)与预后相关,差异均有统计学意义(P<0.05)。PSQI评分大于7分、年龄大于60岁、纤维蛋白原水平大于4 g/L、NIHSS评分大于8分、ONT>4.5 h是预后不良的独立危险因素(优势比=0.728,0.847,0.427,0.619,0.557,P<0.05)。结论AIS患者睡眠质量下降,日间瞌睡倾向明显;预后不良患者睡眠质量下降、日间瞌睡、睡眠呼吸暂停现象较预后良好患者更为明显;PSQI评分大于7分、年龄大于60岁、纤维蛋白原水平大于4 g/L、NIHSS评分大于8分、ONT>4.5 h是预后不良的独立危险因素。
Objective To explore the relationship between sleep disorders and prognosis after acute ischemic stroke(AIS),and to analyze the other risk factors affecting prognosis.Methods A total of 106 cases of AIS admitted and treated in this hospital from December 2019 to December 2020 were selected as the observation group,including 46 cases of good prognosis[modified RANKIN scale(mRS)score 0-2 points,good prognosis group]and 60 cases of poor prognosis(mRS score 3-6 points,poor prognosis group).Contemporaneous 103 subjects undergoing the healthy physical examination were selected as the control group.The Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS)and STOP-Bang Questionnaire(SBQ) were adopted to evaluate the sleep situation in the two groups.The correlation between the PSQI,ESS and SBQ scores with the prognosis was analyzed.The clinical data in the observation group were collected.The relationship between the stroke related risk factors with prognosis was analyzed.Results The PSQI and ESS scores of the observation group were significantly higher than those of the control group.The PSQI,ESS and BSQ scores in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).The PSQI score was positively correlated with poor prognosis(r=0.251,P<0.05).The age,fibrinogen level,blood glucose level,NIHSS score and time from onset to thrombolysis(ONT)were correlated with the prognosis,and the difference was statistically significant(P<0.05).The PSQI score>7 points,age>60 years old,fibrinogen level>4 g/L,NIHSS score>8 points and ONT>4.5 h were the independent risk factors for poor prognosis(OR=0.728,0.847,0.427,0.619,0.557,P<0.05).Conclusion The sleep quality in the patients with AIS is decreased,and the daytime sleepiness tendency is significant.The sleep quality in the patients with poor prognosis is decreased,the daytime sleepiness and sleep apnea phenomenon are more significant compared with the patients with good prognosis.T
作者
王卫华
贺赟
于梦伟
汪可强
陈贵海
WANG Weihua;HE Yun;YU Mengwei;WANG Keqiang;CHEN Guihai(Affiliated Chaohu Hospital,Anhui Medical University,Chaohu,Anhui 238000,China)
出处
《重庆医学》
CAS
2022年第24期4160-4164,共5页
Chongqing medicine
基金
国家自然科学基金面上项目(81671316)
安徽医科大学附属巢湖医院基金面上项目(2018ykj006)。
关键词
急性缺血性卒中
睡眠障碍
危险因素
预后
acute ischemic stroke
sleep disorders
stroke risk factors
stroke prognosis
