本文關(guān)鍵詞： 缺血性腦卒中 急性期 失眠 睡眠結(jié)構(gòu) 多導(dǎo)睡眠監(jiān)測 抑郁　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究輕中度缺血性腦卒中后失眠臨床特點,為臨床診治提供臨床依據(jù)。方法:選取2015年2月至2016年12月在河北醫(yī)科大學(xué)第二醫(yī)院東院區(qū)神經(jīng)內(nèi)科神經(jīng)內(nèi)科住院患者和與之年齡、性別匹配的無腦卒中病史的受試者,共收集40例腦梗死急性期的患者做為病例組,30例無腦梗死者作為對照組,應(yīng)用多導(dǎo)睡眠監(jiān)測儀對兩組的睡眠進(jìn)行監(jiān)測,同時應(yīng)用漢密爾頓抑郁量表對兩組進(jìn)行評分,通過計算機(jī)得出總睡眠時間、入睡潛伏期、睡眠效率、入睡后清醒時間等參數(shù)。應(yīng)用SPSS 21.0軟件進(jìn)行統(tǒng)計分析,統(tǒng)計方法包括t檢驗、卡方檢驗、秩和檢驗等。結(jié)果:1病例組多導(dǎo)睡眠監(jiān)測顯示總的睡眠時間減少[(263.55±15.11)min vs.(349.42±12.57)min]、入睡潛伏期延長[(54.36±3.00)min vs.(27.80±7.81)min]、入睡后清醒時間延長[(180.37±14.90)min vs.(132.08±13.62)min]�；颊叩乃呓Y(jié)構(gòu)發(fā)生紊亂,非快速動眼睡眠期的N1期較對照組延長[(24.00±3.40)min vs.(15.28±2.30)min],非快速動眼睡眠期的N2期睡眠較對照組縮短[(55.04±3.59)min vs.(66.76±2.97)min],均具有統(tǒng)計學(xué)意義(P0.05),而兩組中的非快速動眼睡眠期的N3期和快速動眼睡眠期睡眠時間無統(tǒng)計學(xué)差異(P0.05)。2病例組失眠率為92.7%,遠(yuǎn)高于對照組。3病例組中入睡困難者占65%,入睡后清醒時間延長者占50%,總睡眠時間縮短者占87.5%。4病例組當(dāng)中發(fā)生失眠的有女性17例,男性19例,性別之間僅在REM期存在統(tǒng)計學(xué)差異(P0.05)。5 50歲以下,50-59歲,60-69歲及70歲以上各年齡段之間的總睡眠時間、睡眠效率、入睡后清醒時間、入睡潛伏期及睡眠結(jié)構(gòu)之間無統(tǒng)計學(xué)差異(P0.05),6病例組的漢密爾頓抑郁量表評分高于對照組[(7±3)分vs.(5.5±3.25)分],有統(tǒng)計學(xué)差異(P0.05)。結(jié)論:1輕中度缺血性腦卒中急性期的患者失眠發(fā)生率非常高。2主要表現(xiàn)為睡眠結(jié)構(gòu)發(fā)生發(fā)生紊亂。3缺血性腦卒中急性期失眠患者常常伴發(fā)抑郁情緒。
[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 鹵15.11 vs.(349.42 鹵12.57 min. [54.36 鹵3.00 vs.(27.80 鹵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 鹵3.40 min vs.(15.28 鹵2.30 min). [55.04 鹵3.59 vs.(66.76 鹵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 鹵3) vs.(5.5 鹵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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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