日间嗜睡与急性缺血性卒中短期预后的关系

doi:10.3969/j.issn.1673-5765.2016.11.004

摘要/Abstract

摘要：

目的通过分析急性缺血性卒中患者日间嗜睡及急性期神经功能转归情况，探索日间嗜睡与急性缺血性卒中短期预后之间的关系。方法连续收集2015年6月-2015年9月北京市海淀医院神经内科收治的发病48 h内的住院急性缺血性卒中患者临床资料，包括：人口学特征、既往病史、入院时及发病14 d美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分及入院时日间嗜睡量表[爱波沃斯嗜睡量表（Epworth Sleepiness Scale，ESS）]评分等，回顾性评估患者发病前一个月的ESS评分，分析其与患者基线特点、入院NIHSS评分、入院ESS评分、发病14 d NIHSS评分、发病14 d与发病时NIHSS评分差值（△NIHSS）之间的相关性。根据发病前ESS评分将患者分为嗜睡组和无嗜睡组，比较两组入院时NIHSS、发病 14 d NIHSS、△NIHSS及入院时ESS评分的差异。结果共纳入106例急性缺血性卒中患者。结果显示：①发病前ESS评分与入院时NIHSS评分、发病 14 d NIHSS评分及入院时ESS评分呈正相关，Pearson相关系数分别为0.199、0.276及0.407，P值分别为 0.041、0.004及＜0.001；发病前ESS评分与△NIHSS评分呈负相关，Pearson相关系数为-0.189，P =0.042； ②嗜睡组28例，非嗜睡组78例，嗜睡组入院时NIHSS、发病14 d NIHSS及入院时ESS评分明显高于非嗜睡组，P值分别为0.033、0.043和＜0.001。嗜睡组△NIHSS评分明显低于非嗜睡组，P =0.046。结论发病前存在日间嗜睡的患者在发生急性缺血性卒中后，入院时及发病14 d病情更加严重，短期预后更差，并且卒中后日间嗜睡程度会加重。

关键词: 日间嗜睡; 缺血性卒中; 急性期

Abstract:

Objective By analyzing the relationship between daytime sleepiness and neurological function prognosis in patients with acute stroke, to explore the relationship between daytime sleepiness and acute ischemic stroke. Methods Patients with acute ischemic stroke within 48 hours were consecutively enrolled from Beijing Haidian Hospital during June 2015 to September, 2015. And data were collected including demographics, chronic disease history, National Institutes of Health Stroke Scale (NIHSS) on admission and the 14th day, and Epworth Sleepiness Scale (ESS) on admission. ESS 1 month before admission, which is the premorbid ESS, were retrospectively evaluated. The correlation between premorbid ESS with demographics, chronic disease history, NIHSS on admission and the 14th day, delta NIHSS (the result of NIHSS on admission minus NIHSS of the 14th day) and ESS on admission were analyzed. According to premorbid ESS, patients were divided into sleepiness group and non-sleepiness group, compared NIHSS on admission and the 14th day, delta NIHSS and ESS on admission between two groups. Results One hundred and six patients were consecutively enrolled. The results showed that ① Premorbid ESS had positive correlation with admission NIHSS, the 14th day NIHSS and admission ESS. Pearson correlation coefficient were 0.199, 0.276 and 0.407, and P values were 0.041, 0.004 and <0.001. Premorbid ESS had negative correlation with delta NIHSS. Pearson correlation coefficient was -0.189 and P value was 0.042. ② In daytime sleepiness group, admission NIHSS, the 14th NIHSS and admission ESS were significantly higher than in non-daytime sleepiness group. P values were 0.033, 0.043 and <0.001 respectively. In daytime sleepiness group, delta NIHSS was significantly lower than in non-daytime sleepiness group. P value was 0.046. Conclusion Premorbid daytime sleepiness patients will be more severely on admission and in 14th day, meanwhile their prognosis in the acute phase is worse. The degree of daytime sleepiness will aggravate when ischemic stroke happens.

Key words: Daytime sleepiness; Ischemic stroke; Acute phase

谢子珍，李常红，孟晓梅，于逢春. 日间嗜睡与急性缺血性卒中短期预后的关系[J]. 中国卒中杂志, 2016, 11(11): 918-922.

XIE Zi-Zhen, LI Chang-Hong,MENG Xiao-Mei, et al.. Correlation of Daytime Sleepiness and Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2016, 11(11): 918-922.

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