睡眠质量对青年缺血性卒中短期预后的影响

摘要/Abstract

摘要：

目的研究睡眠质量对青年缺血性卒中短期预后的影响。方法连续性、前瞻性地收集年龄在18～45岁的首发卒中患者223例作为观察对象。建立完善基线资料、青年缺血性卒中预后可能相关因素的数据库，采用匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）问卷评分评估睡眠质量，美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分、改良Rankin量表（modified Rankin Scale，mRS）评分评估其入院后病情及发病后3个月的预后情况，采用单因素及多元Logistic回归分析法对影响青年缺血性卒中预后的相关因素进行分析，并分析研究睡眠质量对青年缺血性卒中短期预后的影响。结果共获取观察组有效病例223例，其中男性170例（76.2%），女性53例（23.8%）。单因素分析结果显示与青年缺血性卒中短期预后的相关因素有：NIHSS评分、睡眠质量、高同型半胱氨酸血症。将上述有意义的变量纳入Logistic回归模型，显示睡眠质量差与青年缺血性卒中3个月mRS评分有关，比值比（odds ratio，OR）1.829；95%可信区间（confidence interval，CI）1.014～3.301。结论睡眠质量差能影响青年缺血性卒中短期预后。

文章导读： 在本研究的病例中，通过单因素和多因素分析显示，睡眠质量差与青年缺血性卒中3个月结局差有
关。

关键词: 青年; 缺血性卒中; 睡眠质量; 短期预后

Abstract:

Objective To study the short-term prognosis of ischemic stroke (IS) in youth. Methods Two hundred twenty-three patients aged 18 to 45 years who were admitted to Puyang People's Hospital from June 2011 to February 2013 with a first-ever ischemic stroke were selected as the research cases. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to analyse the correlation between sleep quality and youth IS incidence; The U.S. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores were used to assess cases' state of illness and prognosis three months after IS. Univariate and multivariate statistical analyses were used to examine risk factors related to youth IS, prognostic factors related to youth IS and the influence of sleep quality on youth ischemic stroke prognosis. Results Of the 223 cases in the observation group, 170 (76.2%) were male, and 53 (23.8%) were female. Univariate analysis showed that risk factors for youth IS prognosis, including, NIHSS score, high homocysteine, poor quality of sleep. Multivariate Logistic regression analysis showed that the association of these risk factors with youth IS prognosis, from NIHSS, high homocysteine, and the quality of sleep. Poor sleep quality was positively correlated with poor prognosis for youth IS patients (odds ratio [OR]:1.829; 95% confidence interval [CI]:1.014~3.301). Conclusion Sleep quality is an important factor in the prognosis of youth IS.

Key words: Youth; Ischemic stroke; Sleep quality; Short-term prognosis

张顺清1，2，张娟3，许予明2，常成4，宋波2，方慧2. 睡眠质量对青年缺血性卒中短期预后的影响[J]. 中国卒中杂志, 2014, 9(11): 924-928.

ZHANG Shun-Qing*,ZHANG Juan, XU Yu-Ming, CHANG Cheng, SONG Bo, FANG Hui.. Influence of Sleep Quality on Young Ischemic Stroke in Short-term Prognosis[J]. Chinese Journal of Stroke, 2014, 9(11): 924-928.

参考文献

1 Putaala J, Metso AJ, Metso TM, et al. Analysis of

1008 consecutive patients aged 15 to 49 with first-ever

ischemic stroke:the Helsinki young stroke registry[J].

Stroke, 2009, 4:1195-1203.

2 Bersano A, Borellini L, Motto C, et al. Molecular

basis of young ischemic stroke[J]. Curr Med Chem,

2013, 20:3818-3839.

3 Gao B, Cam E, Jaeger H, et al. Sleep disruption

aggravates focal cerebral ischemia in the rat[J]. Sleep,

2010, 33:879-887.

4 Yang SS, Jia JP. Differences in risk factors between

anterior and posterior circulation affecting young

ischemic stroke onset and prognosis[J]. Zhonghua Yi

Xue Za Zhi, 2013, 29:348-351.

5 李亚梅, 刘斌, 常永丽. 影响急性脑梗死患者睡眠质量

的相关因素[J]. 中华神经科杂志, 2010, 43:199-203.

6 Adams HP, del Zippo G, Alberts MJ, et al. Guidelines

for the early management of adults with ischemic

st roke:a g uidel i ne f rom the Ame r ican He a r t

Association[J]. Stroke, 2007, 38:1655-1711.

7 Hall ME, do Carmo JM, da Silva AA, et al. Obesity,hypertension, and chronic kidney disease[J]. Int J

Nephrol Renovasc Dis, 2014, 18:75-88.

8 Sa h a SA, Ar o r a R R. Hy p e r l i p i d a emi a a n d

cardiovascular disease:do fibrates have a role?[J]. Curr

Opin Lipidol, 2011, 22:270-276.

9 Castañon MM, Lauricella AM, Kordich L, et al.

Plasma homocysteine cutoff values for venous

thrombosis[J]. Clin Chem Lab Med, 2007, 45:232-236.

10 Zimmet PZ, Magliano DJ, Herman WH, et al.

Diabetes:a 21st century challenge[J]. Lancet Diabetes

Endocrinol, 2014, 2:56-64.

11 Ha shmi AM, Khawaja IS, But t Z, et al. The

Pittsburgh sleep quality index:validation of the Urdu translation[J]. Journal of the College of Physicians

and Surgeons--Pakistan:JCPSP, 2014, 24:123-126.

12 Weisscher N, Vermeulen M, Roos YB, et al. What

should be defined as good outcome in stroke trials;a

modified Rankin score of 0–1 or 0–2?[J]. J Neurol,

2008, 255:867-874.

13 Ferre A, Ribó M, Rodríguez-Luna D, et al. Strokes

and their relationship with sleep and sleep disorders[J].

Neurologia, 2013, 28:103-118.

14 Johnston KC, Wagner DP. Relationship between

3-Month National Institutes of Health Stroke Scale

score and dependence in ischemic stroke patients[J].

Neuroepidemiology, 2006, 27:96-100.

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