进展性脑梗死患者睡眠结构变化的研究

Research on changes of sleep structure in patients with progressive cerebral infarction

摘要:

目的 研究导致脑梗死进展的睡眠结构参数。方法 选取该院神经内科2013 年4 月-2015 年4月住院急性脑梗死患者178 例，根据入院后病情演变分为进展性脑梗死组（观察组）和非进展性脑梗死组（对照组）。入院2 d 之内完成多导睡眠记录。观察总睡眠时间（TST）、睡眠潜伏期（SL）、夜间觉醒次数（AN）、睡眠效率（SE）、睡眠阶段S1、S2、S3、S4 占整个睡眠时间的百分比，快速眼动睡眠（REM）百分比、REM潜伏期（RL）等。通过对口鼻气流、血氧饱和度及鼾声等的监测，得出睡眠呼吸暂停低通气指数（AHI）。结果 观察组的REM、AHI 与对照组比较，差异有统计学意义（P <0.05），观察组的REM 期睡眠比例减少，AHI 增加。结论 进展性脑梗死REM 期睡眠比例减少，睡眠呼吸暂停低通气指数增加，睡眠障碍可作为卒中进展的重要观察指标。

Abstract:

Objective To investigate sleep structure parameters which lead to the progression of cerebral infarction. Methods A total of 178 patients with acute cerebral infarction admitted to the Department of Neurology in our hospital from April 2013 to April 2015 were divided into progressive cerebral infarction group (observation group) and non-progressive cerebral infarction group (control group) according to the evolution of the disease.Polysomnography was completed within 2 days of admission. The total sleep time (TST), sleep latency (SL), nighttime awakening frequency (AN), sleep efficiency (SE), percentage of sleep stage S1, S2, S3, S4 in total sleep time, the percentage of rapid eye movement sleep (REMS) and REM latency (RL) etc were observed. By monitoring the mouth nasal airflow, blood oxygen saturation and snores, sleep apnea hypopnea index (AHI) was calculated. Results Compared to the control group, the REM phase sleep ratio decreased, and AHI significantly increased in the observation group (P < 0.05). Conclusions REM sleep ratio decreases and sleep apnea hypopnea index increases in progressive cerebral infarction. Sleep disorder may be the important indicator for progressive stroke.