轻中度缺血性脑卒中急性期失眠的睡眠周期特点

发布时间：2018-01-20 08:42

本文关键词： 缺血性脑卒中急性期失眠睡眠结构多导睡眠监测抑郁　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究轻中度缺血性脑卒中后失眠临床特点,为临床诊治提供临床依据。方法:选取2015年2月至2016年12月在河北医科大学第二医院东院区神经内科神经内科住院患者和与之年龄、性别匹配的无脑卒中病史的受试者,共收集40例脑梗死急性期的患者做为病例组,30例无脑梗死者作为对照组,应用多导睡眠监测仪对两组的睡眠进行监测,同时应用汉密尔顿抑郁量表对两组进行评分,通过计算机得出总睡眠时间、入睡潜伏期、睡眠效率、入睡后清醒时间等参数。应用SPSS 21.0软件进行统计分析,统计方法包括t检验、卡方检验、秩和检验等。结果:1病例组多导睡眠监测显示总的睡眠时间减少[(263.55±15.11)min vs.(349.42±12.57)min]、入睡潜伏期延长[(54.36±3.00)min vs.(27.80±7.81)min]、入睡后清醒时间延长[(180.37±14.90)min vs.(132.08±13.62)min]。患者的睡眠结构发生紊乱,非快速动眼睡眠期的N1期较对照组延长[(24.00±3.40)min vs.(15.28±2.30)min],非快速动眼睡眠期的N2期睡眠较对照组缩短[(55.04±3.59)min vs.(66.76±2.97)min],均具有统计学意义(P0.05),而两组中的非快速动眼睡眠期的N3期和快速动眼睡眠期睡眠时间无统计学差异(P0.05)。2病例组失眠率为92.7%,远高于对照组。3病例组中入睡困难者占65%,入睡后清醒时间延长者占50%,总睡眠时间缩短者占87.5%。4病例组当中发生失眠的有女性17例,男性19例,性别之间仅在REM期存在统计学差异(P0.05)。5 50岁以下,50-59岁,60-69岁及70岁以上各年龄段之间的总睡眠时间、睡眠效率、入睡后清醒时间、入睡潜伏期及睡眠结构之间无统计学差异(P0.05),6病例组的汉密尔顿抑郁量表评分高于对照组[(7±3)分vs.(5.5±3.25)分],有统计学差异(P0.05)。结论:1轻中度缺血性脑卒中急性期的患者失眠发生率非常高。2主要表现为睡眠结构发生发生紊乱。3缺血性脑卒中急性期失眠患者常常伴发抑郁情绪。
[Abstract]:Objective: to study the clinical features of insomnia after mild to moderate ischemic stroke. Methods: from February 2015 to December 2016, we selected the inpatients and their ages in the Department of Neurology, Department of Neurology, Eastern Department of Neurology, the second Hospital of Hebei Medical University. Sex matched subjects with no history of stroke were collected from 40 patients with acute cerebral infarction as the case group and 30 patients without cerebral infarction as the control group. Polysomnography was used to monitor the sleep of the two groups, and Hamilton Depression scale was used to score the two groups. The total sleep time, sleep latency and sleep efficiency were obtained by computer. SPSS 21.0 software was used for statistical analysis. The statistical methods included t test and chi-square test. Results the polysomnography showed that the total sleep time decreased in the case of 1: 1. [The latency of sleep was prolonged by 263.55 卤15.11 vs.(349.42 卤12.57 min. [54.36 卤3.00 vs.(27.80 卤7.81 min], the waking time was prolonged after falling asleep. [The sleep structure of the patients was disordered, and the N1 stage of non-REM sleep was longer than that of the control group. [The N _ 2 phase sleep in non-REM sleep phase was shorter than that in the control group (24.00 卤3.40 min vs.(15.28 卤2.30 min). [55.04 卤3.59 vs.(66.76 卤2.97 vs.(66.76, all of them have statistical significance (P0.05). There was no significant difference in sleep time between N3 stage and REM sleep stage between the two groups. The insomnia rate of the two groups was 92.7%. It was much higher than that in the control group (65 cases) with difficulty falling asleep, 50 cases with prolonged waking time after falling asleep, and 17 cases with insomnia in 87.5.4 case group (87.5.4 cases). There was only a statistical difference between the two sexes in the REM stage (P0.055.55-50 years old or 50-59 years old). There was no significant difference in total sleep time, sleep efficiency, waking time after falling asleep, sleep latency and sleep structure between 60-69 years and over 70 years old (P 0.05). The Hamilton Depression scale score in 6 cases was higher than that in the control group. [7 卤3) vs.(5.5 卤3. 25). There was statistical difference (P0.05). Conclusion the incidence of insomnia in patients with mild to moderate ischemic stroke is very high. 2. The main manifestation of insomnia is the disorder of sleep structure. 3. The patients with insomnia in acute phase of ischemic stroke often have depression.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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