摘要
目的探讨卒中位置和相关炎症因子与急性脑梗死后睡眠障碍的相关性。方法将2017年3月~2018年9月在我院就诊的急性脑梗死后存在睡眠障碍的患者43例设为观察组;另选取急性脑梗死后无睡眠障碍的患者43例设为对照组;比较两组患者就诊时一般资料、MRI图像、相关炎症因子水平;采用多因素logistics回归方程分析影响卒中后睡眠障碍的相关因素。结果(1)两组患者年龄、性别、血压、卒中家族史、吸烟史等一般资料方面比较差异无统计学意义(P>0.05);(2)MRI影像方面,两组患者梗死类型、病灶数及脑白质脱髓鞘有无之间并无意义(P>0.05);观察组丘脑卒中比例明显高于对照组(P<0.05);(3)两组患者TC、TG、HDL-C、LDL-C比较差异无统计学差异(P>0.05);观察组患者MMP-9、TNF-α、Hcrt、IL-17、IL-1β水平明显高于对照组,差异具有统计学意义(P<0.05);(4)多因素logistics回归分析显示,丘脑卒中(OR=5.970,P=0.048)、IL-17(OR=1.079,P=0.000)、Hcrt(OR=1.155,P=0.011)表达过高是急性脑梗死后睡眠障碍的独立危险因素。结论急性脑梗死后睡眠障碍可能与梗死灶位于丘脑有关,也可能与IL-17及Hcrt过度表达有关。
Objective To investigate the correlation among stroke position,inflammatory factors and after acute cerebral infarction patients with sleep disturbance. Methods A total of 43 patients with sleep disorders after acute cerebral infarction who were admitted to our hospital from March 2017 to September 2018 were enrolled in the observation group. Another 43 patients with no sleep disorder after acute cerebral infarction were selected as controls. Groups;general data,MRI images,and related inflammatory factors levels were compared between the two groups;multivariate logistic regression equations were used to analyze the factors affecting post-stroke sleep disorders. Results (1)There were no significant differences in general data such as age,gender,blood pressure,family history of stroke,and smoking history between the two groups(P>0.05).( 2)There was no difference in the type of infarction,the number of lesions and the demyelination of white matter in the two groups(P>0.05). The proportion of thalamic stroke in the observation group was significantly higher than that in the control group(P<0.05).( 3)There was no significant difference in TC,TG,HDL-C and LDL-C between the two group(P>0.05). The levels of MMP-9,TNF-α,Hcrt,IL-17 and IL-1β in the observation group were higher than those in control group(P<0.05).( 4)Multivariate logistic regression analysis showed that the thalamic stroke(OR=5.970,P=0.048),the level of IL-17(OR=1.079,P=0.000)and Hcrt(OR=1.155,P=0.011)were independent risk factors for sleep disorders after acute cerebral infarction. Conclusion Sleep disorder after acute cerebral infarction may be related to the presence of infarction in the thalamus and the over expression of IL-17 and Hcrt.
作者
直建光
胡建荣
李鹏飞
段保亮
ZHI Jianguang;HU Jianrong;LI Pengfei(General Hospital of Hebi Coal Industry(group)co. ,LTD. ,Hebi 458000,China)
出处
《国际精神病学杂志》
2019年第4期690-692,699,共4页
Journal Of International Psychiatry
