脑梗死后焦虑与睡眠障碍及卒中特异性生存质量的关系

关键词：脑梗死  焦虑  睡眠障碍  生存质量

Keywords:cerebral infarction  anxiety  sleep disorder  quality of life

摘要：

      摘要 目的：探讨脑梗死后焦虑与睡眠障碍及卒中特异性生存质量的关系。 方法：符合研究标准的脑梗死患者170例，经汉密顿焦虑量表(HAMA)评分后分为无焦虑组（72例）和焦虑组（98例）。采用“匹兹堡睡眠质量指数(PSQI)”和“脑卒中影响量表(SIS 3.0)”对患者进行睡眠质量和卒中特异性生存质量的评估，并对焦虑与睡眠质量、生存质量的相关性进行分析。 结果：焦虑组患者PSQI总分及各因子分均高于无焦虑组（P<0.05，P<0.01，P<0.001）。记忆/思维维度的SIS评分焦虑组明显低于无焦虑组（P<0.01）。HAMA总分及精神焦虑因子评分与PSQI总分及除“使用睡眠药物”外的各因子分均有显著性相关性（P<0.01，P<0.001）。躯体焦虑评分与PSQI总分及主观睡眠质量、睡眠潜伏期、睡眠紊乱、日间功能障碍评分具有显著相关性（P<0.05，P<0.001）。HAMA总分及精神焦虑、躯体焦虑因子评分与记忆/思维具有显著相关性（P<0.05，P<0.001）。HAMA总分及躯体焦虑评分与行动能力、手功能评分具有显著相关性（P<0.05，P<0.01）。 结论：脑梗死后焦虑患者睡眠障碍明显，生存质量较差，焦虑对睡眠质量和卒中特异性生存质量存在显著的负面影响。

Abstract:

      Abstract Objective：To investigate the correlation between anxiety and both quality of sleep and stroke-specific quality of life of patients with cerebral infarction. Method： One hundred and seventy ischemic stroke patients were divided into anxiety group（98 cases）and non-anxiety group（72 cases）according to their Hamilton anxiety scale(HAMA) scores. After routine treatment of western medicine for 2 weeks, quality of sleep was evaluated with Pittsburgh Sleep Quality Index（PSQI）and stroke-specific quality of life was assessed with Stroke Impact Scale 3.0(SIS 3.0). Correlation analysis was performed between anxiety and both quality of sleep and stroke-specific quality of life. Result： Compared with non-anxiety patients, patients with anxiety had lower scores in memory/thinking dimension of SIS（P<0.01）and higher scores in PSQI overall scores and all the factors of PSQI. HAMA overall scores and mental anxiety factor scores were closely related to PSQI overall scores as well as all the factor scores except for medication scores（P<0.01，P<0.001）. Somatic anxiety scores were related to subjective sleep quality, sleep latency, sleep disturbance and daily dysfunction and overall PSQI scores（P<0.05，P<0.001）. HAMA overall scores, mental anxiety and somatic anxiety factor scores were significantly correlated to memory/thinking scores（P<0.05，P<0.001）. HAMA overall scores and somatic anxiety scores were correlated to mobile function and hand function scores（P<0.05，P<0.01）. Conclusion：Cerebral infarction patients with anxiety had worse quality of sleep and lower stroke-specific quality of life. Stroke-specific quality of life and quality of sleep in cerebral infarction patients were negatively influenced by anxiety.