本文關(guān)鍵詞：卒中后睡眠障礙與認(rèn)知障礙，由筆耕文化傳播整理發(fā)布。

        目的：本研究旨在研究腦卒中(Stroke)后睡眠障礙(Sleep Disorders)與認(rèn)知障礙(Cognitive Impairment)及其相關(guān)因素，為臨床診治提供理論依據(jù)。方法：收集2013年5月至2014年1月在河北醫(yī)科大學(xué)第四醫(yī)院神經(jīng)內(nèi)科住院患者，均經(jīng)頭顱CT或頭顱磁共振成像(Magnetic Resonance Imaging,MRI)檢查，符合腦出血或腦梗死患者62例，診斷標(biāo)準(zhǔn)參考1995年中華醫(yī)學(xué)會(huì)全國(guó)第四屆腦血管病學(xué)術(shù)會(huì)議修訂的診斷標(biāo)準(zhǔn)。年齡51～90歲，平均年齡68.61±9.75歲，其中男性41例，女性21例，合并高血壓病46例，糖尿病32例，冠心病20例，出血性卒中12例，缺血性卒中50例，發(fā)病前無睡眠障礙及認(rèn)知障礙史�；颊呔谌朐�2周內(nèi)進(jìn)行匹茲堡睡眠量表（PittsburghSleep Quality Index, PSQI）評(píng)分、多導(dǎo)睡眠圖（Polysomnography, PSG）進(jìn)行睡眠監(jiān)測(cè)，分析腦卒中患者睡眠質(zhì)量改變情況；用簡(jiǎn)易精神狀態(tài)量表（Mini-mental State Examination, MMSE）、事件相關(guān)電位（Event-RelatedPotentials, ERP）P300對(duì)腦卒中患者進(jìn)行認(rèn)知功能評(píng)價(jià)，分析腦卒中后患者認(rèn)知障礙情況。PSQI總分為2l分，0～6分表示正常，≥7分表示存在睡眠障礙。MMSE最高分為30分，認(rèn)知障礙診斷標(biāo)準(zhǔn)經(jīng)過受教育程度及年限校正：文盲≤17分，小學(xué)≤20分，中學(xué)及以上組≤24分。神經(jīng)功能缺損程度評(píng)分采用腦卒中臨床神經(jīng)功能缺損程度評(píng)分量表（NDS），總分為45分，0～15分為輕度神經(jīng)功能缺損，16～30分為中度神經(jīng)功能缺損，31～45分為重度神經(jīng)功能缺損。依據(jù)PSQI評(píng)分標(biāo)準(zhǔn)將全部患者分為：①睡眠障礙組22例，年齡52～90歲，平均年齡70.82±10.76歲，其中男性14例，女性8例；②非睡眠障礙組40例，年齡51～88歲，平均年齡67.40±9.07歲，其中男性27例，女性13例；依據(jù)MMSE診斷標(biāo)準(zhǔn)將全部患者分為：①認(rèn)知障礙組20例，年齡53～88歲，平均年齡71.55±9.46歲，其中男性11例，女性9例；②非認(rèn)知障礙組42例，年齡51～90歲，平均年齡67.21±9.69歲，其中男性30例，女性12例。分別對(duì)①②兩組臨床資料（性別、年齡、既往病史、卒中性質(zhì)、卒中部位、神經(jīng)功能缺損程度）、多導(dǎo)睡眠圖（睡眠潛伏期、實(shí)際睡眠時(shí)間、睡眠效率、覺醒次數(shù)、非快速動(dòng)眼睡眠1期比例、非快速動(dòng)眼睡眠2期比例、非快速動(dòng)眼睡眠3,4期比例、快速動(dòng)眼睡眠期比例)及P300（潛伏期、波幅）進(jìn)行對(duì)比分析。應(yīng)用SPSS13.0統(tǒng)計(jì)學(xué)軟件對(duì)資料進(jìn)行統(tǒng)計(jì)學(xué)分析，計(jì)數(shù)資料以百分?jǐn)?shù)表示，采用2檢驗(yàn)，計(jì)量資料進(jìn)行正態(tài)性檢驗(yàn)，用x±s表示，采用t檢驗(yàn)，P<0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果：1卒中后睡眠障礙1.1一般資料對(duì)睡眠障礙組與非睡眠障礙組性別、年齡進(jìn)行對(duì)比，睡眠障礙組22例，其中男性14例（63.64%），女性8例（36.36%），男女比例為1.75:1，年齡最大為90歲，最小為52歲，平均年齡70.82±10.76歲；非睡眠障礙組40例，其中男性27例（67.50%），女性13例（32.50%），男女比例為2.07:1，年齡最大為88歲，最小為51歲，平均年齡67.40±9.07歲。各年齡段中：≤60歲患者16例，有睡眠障礙者5例（5/16，31.25%），61～70歲患者18例，有睡眠障礙者6例（6/18，33.33%），71～80歲患者19例，有睡眠障礙者4例（4/19，21.05%），>80歲患者9例，有睡眠障礙者7例，（7/9，77.78%）。統(tǒng)計(jì)學(xué)分析顯示：兩組性別、平均年齡比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。各年齡段睡眠障礙發(fā)生率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。1.2臨床資料對(duì)睡眠障礙組與非睡眠障礙組既往病史（高血壓病、糖尿病、冠心�。�、卒中性質(zhì)、卒中側(cè)別、卒中部位、神經(jīng)功能缺損程度進(jìn)行比較顯示：睡眠障礙組22例，其中合并高血壓病20例（20/22，90.91%），糖尿病16例（16/22，72.73%），冠心病11例（11/22，50.00%）；非睡眠障礙組40例，其中合并高血壓病26例（26/40，65.00%），糖尿病16例（16/40，40.00%），冠心病9例（9/40，22.50%），兩組既往病史（高血壓病、糖尿病、冠心�。┻M(jìn)行比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)卒中性質(zhì)進(jìn)行比較：出血性卒中12例，出現(xiàn)睡眠障礙者5例(5/12，41.67%），缺血性卒中50例，出現(xiàn)睡眠障礙者17例（17/50，34.00%），兩組比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。對(duì)兩組卒中側(cè)別進(jìn)行比較顯示：左側(cè)半球病變32例，出現(xiàn)睡眠障礙者17例（17/32，53.13%），右側(cè)半球病變30例，出現(xiàn)睡眠障礙者5例（5/30，16.67%），兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)兩組卒中部位進(jìn)行比較顯示：額葉病變4例，睡眠障礙者1例（1/4，25.00%）；顳葉病變3例，睡眠障礙者1例（1/3，33.33%）；頂葉病變2例，睡眠障礙者2例（2/2，100.00%）；枕葉病變3例，睡眠障礙者1例（1/3，33.33%）；基底節(jié)區(qū)病變28例，睡眠障礙者8例（8/28，28.57%）；腦干病變者14例，睡眠障礙8例（8/14，57.14%）；丘腦病變5例，睡眠障礙者1例（1/5，20.00%）。由于樣本含量較少，兩者無法進(jìn)行統(tǒng)計(jì)學(xué)分析。對(duì)神經(jīng)功能缺損程度進(jìn)行比較：輕度神經(jīng)功能缺損患者35例，存在睡眠障礙者7例（7/35，20.00%）；中度神經(jīng)功能缺損患者19例，存在睡眠障礙者9例（9/19，47.37%）；重度神經(jīng)功能缺損患者8例，存在睡眠障礙者6例（6/8，75.00%），統(tǒng)計(jì)學(xué)分析顯示不同程度神經(jīng)功能缺損組睡眠障礙發(fā)生率差別有統(tǒng)計(jì)學(xué)意義（P<0.05）。1.3多導(dǎo)睡眠圖表現(xiàn)分別對(duì)卒中后睡眠障礙組與非睡眠障礙組PSG進(jìn)行比較顯示：睡眠障礙組睡眠潛伏期為52.86±13.85min，實(shí)際睡眠時(shí)間為387.59±31.96min，睡眠效率為80.75±6.66%，覺醒次數(shù)為6.05±2.01，非快速動(dòng)眼睡眠1期比例22.22±6.47%，非快速動(dòng)眼睡眠2期比例44.24±4.93%，非快速動(dòng)眼睡眠3,4期比例11.97±4.36%，快速動(dòng)眼睡眠期比例10.38±3.98%；非睡眠障礙組睡眠潛伏期為31.43±9.19min，實(shí)際睡眠時(shí)間為410.48±15.71min，睡眠效率85.72±3.29%，覺醒次數(shù)為4.45±2.18，非快速動(dòng)眼睡眠1期比例14.91±5.18%，非快速動(dòng)眼睡眠2期比例41.69±4.71%，非快速動(dòng)眼睡眠3,4期比例15.05±4.58%，快速動(dòng)眼睡眠期期比例13.34±4.24%。兩組在睡眠潛伏期、實(shí)際睡眠時(shí)間、睡眠效率、覺醒次數(shù)、各期比例方面比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。1.4P300對(duì)卒中后睡眠障礙組與非睡眠障礙組P300進(jìn)行比較顯示：睡眠障礙組P300潛伏期為386.95±68.75ms，波幅為6.45±1.83uV；非睡眠障礙組P300潛伏期為359.05±51.89ms，波幅為7.23±1.63uV。經(jīng)統(tǒng)計(jì)學(xué)分析顯示兩組比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。2卒中后認(rèn)知障礙2.1一般資料對(duì)認(rèn)知障礙組與非認(rèn)知障礙組進(jìn)行性別、年齡比較分析顯示：認(rèn)知障礙組20例，其中男性11例（11/20，55.00%），女性9例（9/29，45.00%），男女比例為1.22:1，年齡最大為88歲，最小為53歲，平均年齡71.55±9.46歲；非認(rèn)知障礙組42例，其中男性30例（30/42，71.43%），女性12例（12/42，28.57%），男女比例為2.50:1，年齡最大為90歲，最小為51歲，平均年齡67.21±9.69歲。各年齡段中：≤60歲患者16例，有認(rèn)知障礙者2例（2/16，12.50%），61～70歲患者18例，有認(rèn)知障礙者5例（5/18，27.78%），71～80歲患者19例，有認(rèn)知障礙者7例（7/19，36.84%），>80歲患者9例，有認(rèn)知障礙者6例（6/9，66.67%）。統(tǒng)計(jì)學(xué)分析顯示兩組進(jìn)行性別、平均年齡比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。各年齡段認(rèn)知障礙發(fā)生率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。2.2臨床資料對(duì)認(rèn)知障礙組與非認(rèn)知障礙組既往病史（高血壓病、糖尿病、冠心�。�、卒中性質(zhì)、卒中側(cè)別、卒中部位、神經(jīng)功能缺損程度進(jìn)行比較顯示：認(rèn)知障礙組20例中合并高血壓病19例（19/20，95.00%），糖尿病15例（15/20，75.00%），冠心病10例（10/20，50.00%）；非認(rèn)知障礙組42例中合并高血壓病27例（27/42，，64.29%），糖尿病17例（17/42，40.48%），冠心病10例（10/42，23.81%），兩組既往病史（高血壓病、糖尿病、冠心�。┻M(jìn)行比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)卒中性質(zhì)進(jìn)行比較：出血性卒中12例，存在認(rèn)知障礙者6例（6/12，50.00%）；缺血性卒中50例，存在認(rèn)知障礙者14例（14/50，28.00%），兩者比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。對(duì)兩組卒中側(cè)別進(jìn)行比較：左側(cè)半球病變者32例，認(rèn)知障礙者14例（14/32，43.75%）；右側(cè)半球病變者30例，認(rèn)知障礙者6例（6/30，20.00%），對(duì)卒中側(cè)別進(jìn)行比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)卒中部位進(jìn)行比較：額葉病變4例，認(rèn)知障礙者2例（2/4，50.00%）；顳葉病變3例，認(rèn)知障礙2例（2/3，66.67%）；枕葉病變3例，認(rèn)知障礙者1例（1/3，33.33%）；基底節(jié)區(qū)病變28例，認(rèn)知障礙8例（8/28，28.57%）；腦干病變14例，認(rèn)知障礙3例（3/14，21.43%）；小腦病變3例，認(rèn)知障礙者1例（1/3，33.33%）；丘腦病變5例，認(rèn)知障礙3例（3/5，60.00%）。由于本研究樣本量較少，兩者無法進(jìn)行統(tǒng)計(jì)學(xué)分析。對(duì)神經(jīng)功能缺損程度分析顯示：輕度神經(jīng)功能缺損患者35例，存在認(rèn)知障礙者8例（8/35，22.86%）；中度神經(jīng)功能缺損患者19例，存在認(rèn)知障礙者6例（6/19，31.58%）；重度神經(jīng)功能缺損患者8例，存在認(rèn)知障礙者6例（6/8，75.00%），經(jīng)統(tǒng)計(jì)學(xué)分析，不同程度神經(jīng)功能缺損組認(rèn)知障礙發(fā)生率差別有統(tǒng)計(jì)學(xué)意義（P<0.05）。2.3事件相關(guān)電位P300表現(xiàn)對(duì)認(rèn)知障礙組與非認(rèn)知障礙組P300潛伏期及波幅進(jìn)行比較：認(rèn)知障礙組P300潛伏期為437.90±40.08ms，波幅為6.42±1.24uV；非認(rèn)知障礙組P300潛伏期為336.12±32.94ms，波幅為7.25±1.86uV，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。2.4PSG表現(xiàn)認(rèn)知障礙組睡眠潛伏期為43.55±17.47min，實(shí)際睡眠時(shí)間為395.25±33.32min，睡眠效率為82.35±6.94%，覺醒次數(shù)為5.60±2.01，非快速動(dòng)眼睡眠1期比例為20.93±7.90%，非快速動(dòng)眼睡眠2期比例為43.76±5.02%，非快速動(dòng)眼睡眠3,4期比例為13.65±4.21%，快速動(dòng)眼睡眠期比例為10.69±3.87%；非認(rèn)知障礙組睡眠潛伏期為36.88±13.48min，實(shí)際睡眠時(shí)間為405.74±19.71min，睡眠效率為84.53±4.11%，覺醒次數(shù)為4.83±2.38，非快速動(dòng)眼睡眠1期比例為15.88±5.29%，非快速動(dòng)眼睡眠2期比例為42.04±4.81%，非快速動(dòng)眼睡眠3,4期比例為14.11±4.96%，快速動(dòng)眼睡眠期比例為13.05±4.41%。兩者在非快速動(dòng)眼睡眠1期比例、快速動(dòng)眼睡眠期比例方面差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。睡眠潛伏期、實(shí)際睡眠時(shí)間、睡眠效率、覺醒次數(shù)、非快速動(dòng)眼睡眠2期及非快速動(dòng)眼睡眠3,4期比例比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：1卒中后睡眠障礙與既往病史（高血壓病、糖尿病、冠心�。�、卒中側(cè)別及神經(jīng)功能缺損程度有相關(guān)性。2卒中后睡眠障礙患者多導(dǎo)睡眠圖表現(xiàn)為睡眠潛伏期延長(zhǎng)，實(shí)際睡眠時(shí)間減少，睡眠效率降低，覺醒次數(shù)增加，非快速動(dòng)眼睡眠1、2期比例增加，非快速動(dòng)眼睡眠3,4期、快速動(dòng)眼睡眠期比例減少。3卒中后認(rèn)知障礙與既往病史（高血壓病、糖尿病、冠心�。�、卒中側(cè)別及神經(jīng)功能缺損程度有相關(guān)性。4卒中后認(rèn)知障礙患者P300潛伏期延長(zhǎng)，波幅降低，多導(dǎo)睡眠圖表現(xiàn)為非快速動(dòng)眼睡眠1期比例增加，快速動(dòng)眼睡眠期比例減少。

    Objective:To investigate the clinical characteristics of sleep disordersand cognitive impairment after stroke.Methods:We screened a cohort of62patients diagnosed with strokeaccording to the revised diagnostic criteria of the Chinese society of the fourthsession of national cerebrovascular disease academic meeting in1995at theFourth Affiliated Hospital of Hebei Medical University from May2013toJanuary2014.This cohort included41males and21female, with a mean ageof68.61±9.75years(range,51-90years). Complications included hypertension(n=46), diabetes mellitus (n=32) and coronary heart disease (n=20). Thehemorrhagic cases were12and the ischemic cases were50. These patients hadneither sleep disorders nor cognitive impairment before the onset of stroke,and were examined with Pittsburgh Sleep Quality Index (PSQI), Mini-mentalState Examination(MMSE), Event-related potentials(P300) and monitored byPolysomnography(PSG)within two weeks after hospitalization. The totalglobal PSQI score was21. A PSQI global score greater than7was classifiedas the sleep disorder. The maximal point of MMSE was30, The raw scoremay also need to be corrected for educational attainment and age,illiteracy≤17points, primary school≤20points, above the middle school≤24points. The stroke clinical neurological deficit rating scale (NDS) score was45points,0-15points as mild neurological deficit,16-30as moderate neurologicaldeficit,31-45as severe neurological deficit. The patients were divided intotwo groups according to PSQI:①22cases in the sleep disorders group (14males,8females,52-90years of age, mean age70.82±10.76years),②40cases in the non-sleep disorders group (27males,13females,51-88years ofage, mean age67.40±9.07years). The patients were divided into two groupsaccording to MMSE.①20cases in the cognitive impairment group (11males,9females,53-88years of age, mean age71.55±9.46years),②42cases in the non-cognitive impairment group (30males,12females,51-90years of age,mean age67.21±9.69years).The clinical data (including gender, age,anamnesis, stroke type, stroke location, neurological deficit), PSG (the sleeplatency, actual sleep time, sleep efficiency, awake times, the ratio of non-rapideye movement1,2,3,4and rapid eye movement) and P300(The latency andamplitude) was analyzed, and SPSS13.0software was used for all analysis.The data is expressed as a percentage, and campared by chi-square test forcategorical variables, and2-sample t test depending on the distribution ofcontinuous variable. a P value <0.05was considered as statisticallysignificant.Results:1Sleep disorders1.1Common data: The sleep disorders patients (n=22) weremales(14/22,63.64%), females (8/22,36.36%) and the non-sleep disorderspatients(n=40) were males(27/40,67.50%),females (13/40,32.50%),The genderwas not statistically associated with the sleep disorders. The mean age was70.82±10.76years (range52-90years) in patients with sleep disorders and67.40±9.07years(range51-88years) without sleep disorders. It showed thatthere was no statistically significant (P>0.05) at the average age. Less than60years(5/16,31.25%),61～70years(6/18,33.33%),71～80years(4/19,21.05%),more than80years(7/9,77.78%),we found statistically significant(P<0.05) in all ages.1.2Clinical features: Compared the two groups for the anamnesis(hypertension, diabetes mellitus, coronary heart disease), stroke type, strokelocation and neurological deficit. In sleep disorders group, hypertension(20/22,90.91%),diabetes mellitus(16/22,72.73%),coronary heart disease(11/22,50.00%). In the non-sleep disorders group, hypertension(26/40,65.00%),diabetes mellitus (16/40,40.00%), coronary heart disease (9/40,22.50%).Prevalence of sleep disorders was significantly (P<0.05) related to theanamnesis (hypertension,diabetes mellitus,coronary heart disease). Theischemic stroke were50cases (17/50,34.00%) and hemorrhagic stroke were 12cases (5/12,41.67%), and there was no statistically significant (P>0.05).The left cerebral hemisphere32cases (17/32,53.13%), the right cerebralhemisphere30cases (5/30,16.67%), there was statistically significant (P<0.05)at the stroke side. The incidence of sleep disorders group for the frontal, thetemporal, the parietal, the occipital, the basal ganglia, the brainstem, and thethalamus stroke were (1/4,25.00%),(1/3,33.33%),(2/2,100%),(1/3,33.33%),(8/28,28.57%),(8/14,57.14%）,(1/5,20.00%),The data can not be statisticallyanalyzed because of the small sample content. The mild neurological deficitwere35(7/35,20.00%), the moderate neurological deficit were19(9/19,47.37%), the severe neurological deficit were8(6/8,75.00%), and there wasstatistically significant (P<0.05).1.3PSG the sleep latency were52.86±13.85min (the sleep disorders group),31.43±9.19min(the non-sleep disorders group) and the actual sleep time were387.59±31.96min versus410.48±15.71min. The sleep efficiency were80.75±6.66%versus85.72±3.29%. The awake times were6.05±2.01versus4.45±2.18. The ratio of NREM1,2,3,4and REM as follows:22.22±6.47%,44.24±4.93%,11.97±4.36%,10.38±3.98%(the sleep disordersgroup)and14.91±5.18%,41.69±4.71%,15.05±4.58%,13.34±4.24%(the non-sl-eep disorders group). We found statistically significant(P<0.05) between thetwo groups.1.4Event-related potentials (P300) The latency and the amplitude were386.95±68.75ms,6.45±1.83uV (the sleep disorders group)and359.05±51.89ms,7.23±1.63uV(the non-sleep disorders group). There was no statisticallysignificant (P>0.05).2Cognitive impairment2.1Common data The cognitive impairment group (n=20),11males(11/20,55.00%),9females (9/20,45.00%), mean age71.55±9.46years (range53-88years) and30males (30/42,71.43%),12females (12/42,28.57%), meanage67.21±9.69years (range51-90years) in the non-cognitive impairmentgroup. We found there was no statistically significant (P>0.05). In all ages:less than60years(2/16,12.50%),61～70years(5/18,27.78%),71～80years (7/19,36.84%), more than80years (6/9,66.67%) and there was statisticallysignificant (P<0.05)in all ages.2.2Clinical features Compared the two groups for the anamnesis(hypertension, diabetes mellitus, coronary heart disease), stroke type, strokelocation and neurological deficit. The cognitive impairment patients withhypertension(19/20,95.00%), diabetes mellitus(15/20,75.00%), coronary heartdisease (10/20,50.00%) and hypertension (27/42,64.29%), diabetes mellitus(17/42,40.48%), coronary heart disease (10/42,23.81%) in the non-cognitiveimpairment group, the anamnesis showed significant association withprevalence of cognitive impairment(P<0.05). The prevalence of cognitiveimpairment(14/50,28.00%)in ischemic stroke and (6/12,50.00%) inhemorrhagic stroke, and there was no statistically significant(P>0.05). The leftcerebral hemisphere were32(14/32,43.75%), the right cerebral hemispherewere30(6/30,20.00%）and there was statistically significant (P<0.05) at thestroke side. The incidence of the cognitive impairment group for the frontal,the temporal, the occipital, the basal ganglia, the brainstem, the cerebellumand the thalamus were(2/4,50.00%),(2/3,66.67%),(1/3,33.33%),(8/28,28.57%),(3/14,21.43%),(1/3,33.33%),(3/5,60.00%).The data can not be statisticallyanalyzed because of the small sample content. The mild neurological deficitwere35(8/35,22.86%), the moderate neurological deficit were19(6/19,31.58%), the severe neurological deficit were8(6/8,75.00%), andthere was statistically significant(P<0.05).2.3Event-related potentials (P300) The latency was437.90±40.08ms andthe amplitude was6.42±1.24uV (the cognitive impairment group) and336.12±32.94ms,7.25±1.86uV(the non-cognitive impairment group). Therewas statistically significant(P<0.05).2.4PSG The cognitive impairment group, the sleep latency43.55±17.47min,the actual sleep time395.25±33.32min, the sleep efficiency82.35±6.94%,awake times5.60±2.01, the ratio of NREM1,2,3,4and REM were20.93±7.90%,43.76±5.02%,13.65±4.21%,10.69±3.87%.The non-cognitive impairmentgroup were36.88±13.48min,405.74±19.71min,84.53±4.11%,4.83±2.38, 42.04±4.81%,14.11±4.96%,13.05±4.41%. We found statistically significant atthe ratio of NREM1and REM(P<0.05). The sleep latency, the actual sleeptime, the sleep efficiency, awake times and the ratio of NREM2, NREM3,4were no statistically significant(P>0.05).Conclusion:1The sleep disorders was associated with the anamnesis(hypertension,diabetes mellitus, coronary heart disease), stroke side and neurological deficit.2The sleep disorders showed the reduced actual sleep time, sleepefficiency, the ratio of NREM3,4, REM and prolonged sleep latency, awaketimes, the ratio of NREM1,2.3The cognitive impairment patients were related to the anamnesis(hypertension,diabetes mellitus,coronary heart disease),stroke side andneurological deficit.4The cognitive impairment patients had prolonged latency, reducedamplitude and increased ratio of NREM1, decreased ratio of REM.

卒中后睡眠障礙與認(rèn)知障礙

摘要4-9ABSTRACT9-13前言14材料與方法14-16結(jié)果16-21附圖21-26附表26-31討論31-38結(jié)論38參考文獻(xiàn)38-43綜述 卒中后睡眠障礙與認(rèn)知障礙43-53    參考文獻(xiàn)48-53致謝53-54個(gè)人簡(jiǎn)歷54

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