青海地区非致残性缺血性脑血管事件患者90天转归情况及睡眠质量评测

发布时间：2018-08-24 14:44

【摘要】：目的调查青海地区非致残性缺血性脑血管事件(Non-disabling Ischemic Cerebrovascular Events,NICE)患者90天转归情况以及睡眠障碍的发生率,同时探讨NICE患者出现睡眠障碍可能的危险因素。方法连续纳入发病7天内住院的青海地区NICE患者,发病90±7天面对面随访,访视内容包括:完成mRS量表(modified Rankin Scale,mRS)、PSQI量表(Pittsburgh Sleep Quality Index)及ESS量表(Epworth Sleepiness Scale)。NICE睡眠障碍定义为PSQI量表评分≥11分。采用多变量logistic回归分析明确青海地区NICE睡眠障碍的可能危险因素。结果发病90±7天时成功随访132例,其中转归不良(mRS≥3分)者42例(31.8%),NICE睡眠障碍者60例(45.5%),而有42例(31.8%)存在日间嗜睡情况(ESS6分)。进行多变量logistic回归分析显示,肥胖(优势比(odds ratio,OR)4.550,95%可信区间(95%confidence interval,95%CI),2.374~11.451,p=0.009)、转归不良(OR 8.545,95%CI,1.869~49.978,p=0.002)、日间嗜睡(OR 1.129,95%CI,1.069~2.978,p=0.048)、后循环病变(OR 1.223,95%CI,1.029~3.547,p=0.042)、高海拔居住(OR 1.345,95%CI,1.063~4.978,p=0.039)、合并高原红细胞增多症(High altitude polycythemia,HAPC)(OR 2.374,95%CI,1.679~5.263,p=0.023)是NICE 90天存在睡眠障碍的独立危险因素。进一步筛选出高海拔居住者45例进行分析,其中合并高粘滞血症的高海拔患者睡眠障碍发生率(18/23)显著高于非高粘滞血症的高海拔患者(8/22),差异有统计学意义(χ~2=8.091,p=0.004)。合并HAPC的高海拔患者睡眠障碍发生率(16/22)显著高于非HAPC的高海拔患者(10/23),差异有统计学意义(χ~2=3.943,p=0.047)。结论1.90天访视时31.8%的NICE患者转归不良。2.较高比例的NICE患者出现睡眠障碍(45.5%)和日间嗜睡(31.8%)情况。3.高海拔居住、合并高原红细胞增多症是青海地区NICE睡眠障碍的重要危险因素。
[Abstract]:Objective to investigate the outcome of 90 days and the incidence of sleep disorders in patients with non-disabled ischemic cerebrovascular events (Non-disabling Ischemic Cerebrovascular Events,NICE) in Qinghai area, and to explore the possible risk factors of sleep disorders in patients with NICE. Methods the patients with NICE in Qinghai area who were hospitalized within 7 days were followed up face to face for 90 卤7 days. The contents of interview included: complete mRS scale (modified Rankin Scale,mRS, (Pittsburgh Sleep Quality Index) and ESS scale (Epworth Sleepiness Scale). Nice Sleep Disorder was defined as PSQI score 鈮，

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