急性脑梗死后不宁腿综合征

发布时间：2018-04-23 02:16

本文选题：急性脑梗死 + 不宁腿综合征　；参考：《南昌大学》2014年硕士论文

【摘要】：目的：分析急性脑梗死后出现不宁腿综合征（restless legs syndrome,RLS）的患病率以及其临床特点。分析急性脑梗死后RLS对梗死的预后及转归的影响，为急性脑梗死的治疗及康复提供新思路。方法：本研究选取2012年5月-2013年5月期间275例急性脑梗死患者，其中符合国际RLS诊断标准诊断及多巴胺试验阳性患者为RLS组，按RLS患者的年龄、性别及梗死部位筛选出条件匹配的急性脑梗死未出现RLS的患者为非RLS组。RLS组患者均行多导睡眠图检查（polysomnographic，，PSG），予以普拉克索（25mg/次，每晚一次）治疗，分析急性脑梗死后RLS中可能相关危险因素及临床特点，对RLS组与非RLS组患者患病7天内以及预后90天、180天的临床康复情况进行比较。结果：275例急性脑梗死患者符合入选标准，其中RLS组患者19例（19/275，6.91%），年龄62.89±10.26岁；非RLS组，年龄62.63±9.96。在RLS组，RLS症状出现时间平均在卒中后1.68±0.82天，6例（31.6%）出现在梗死部位支配侧肢体，13例（68.4%）双下肢出现；急性脑梗死部位不同出现RLS的患病率有所不同。RLS组与非RLS组比较示RLS组的血红蛋白含量较低，日间过度睡眠（ESS10)（χ2=5.40，P=0.02），RLS组（11/19，57.9%）高于非RLS组（4/19，21.1%），主观睡眠质量差（PSQI15）（χ2=4.39，P=0.04），RLS组（9/19，47.4%）高于非RLS组（3/19，15.8%）。在RLS组，中重呼吸暂停综合征（OSAHS，AHI15）的患病率为9/19（47.4%），周期性腿动重度（PLMS，PLMSI25）的患病率为68.42%（13/19），对比梗死后90天及180天的BI及mRS示RLS组不及非RLS组。结论：急性脑梗死后不宁腿综合征的发病机理与多巴胺能神经元及中枢感觉运动神经通路受损有关。梗死后RLS患者易出现日间疲劳及主观嗜睡，较非RLS组预后差。
[Abstract]:Objective: to analyze the prevalence and clinical characteristics of restless legs syndrome after acute cerebral infarction. To analyze the influence of RLS on the prognosis and prognosis of acute cerebral infarction (ACI) and to provide new ideas for the treatment and rehabilitation of acute cerebral infarction (ACI). Methods: 275 patients with acute cerebral infarction (ACI) from May 2012 to May 2013 were selected as RLS group according to the age of RLS patients. The patients without RLS in the non-RLS group who were screened out by sex and infarct location were all treated with polysomnographicus PSG by polysomnography, which were treated with Praxol 25mg / time, once a night, and the patients in the RLS group were all treated with polysomnography. To analyze the possible risk factors and clinical characteristics of RLS after acute cerebral infarction, and to compare the clinical rehabilitation of RLS group with that of non- group within 7 days and the prognosis of 90 days to 180 days. Results one hundred and seventy-five patients with acute cerebral infarction met the inclusion criteria, including 19 patients with 19 / 2756.91 and 62.89 卤10.26 years of age in RLS group, and 62.63 卤9.96 in non- group. In the RLS group, the mean onset time of RLS symptoms was 1.68 卤0.82 days after stroke in 6 cases (31.6%). The prevalence of RLS was different between RLS group and non-RLS group. The hemoglobin content in RLS group was lower than that in non-RLS group. The incidence of RLS in RLS group was higher than that in non- group (蠂 2 5.40 P 0.02 0. 02%) higher than that in non- group. The subjective sleep quality of RLS group was lower than that of non- group. In the RLS group, the prevalence of OSAHS AHI15 was 9 / 19 / 47.4, and the incidence of periodic leg movement was 68.42 / 19 / 19. The BI and mRS of 90 and 180 days after infarction showed that the RLS group was not as good as the non- group. Conclusion: the pathogenesis of restless leg syndrome after acute cerebral infarction is related to the damage of dopaminergic neurons and central sensory motor pathway. Day fatigue and subjective sleepiness were more common in patients with RLS after infarction than in non- group.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】