摘要
目的探讨丁苯酞氯化钠注射液联合阿司匹林、氯吡格雷双重抗血小板治疗进展性脑梗死患者睡眠障碍的疗效及对睡眠结构的影响。方法选取2013年4月-2015年12月于保定市第二医院神经内科住院患者共206例,均符合进展性脑梗死合并睡眠障碍,随机分为治疗组(加用丁苯酞氯化钠注射液治疗)103例及对照组103例(不加用丁苯酞氯化钠注射液治疗),发病时间在48 h内,匹兹堡睡眠质量指数(PSQI)≥8分。分别于治疗前、治疗后第8、15及30天进行PSQI、NIHSS评分和Barthel评分,入组第1及30天进行多导睡眠监测,对PSQI、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力评定量表(Barthel)评分、睡眠结构及进程参数进行分析。结果治疗后第15和30天,治疗组与治疗前同组及同期对照组比较,PSQI、NIHSS评分及Barthel评分,差异有统计学意义(P<0.05)。治疗组与对照组治疗后30 d比较,总睡眠时间、睡眠效率及深睡眠比例增加,夜间觉醒次数、睡眠呼吸暂停低通气指数减少(P<0.05)。治疗组治疗后30 d与治疗前比较,总睡眠时间、睡眠效率、深睡眠比例及REM期睡眠比例增加,入睡潜伏期、夜间觉醒次数及睡眠呼吸暂停低通气指数减少(P<0.05)。结论丁苯酞氯化钠注射液联合阿司匹林、氯吡格雷对进展性脑梗死后睡眠障碍可进行有效干预,并改善睡眠结构。
Objective To investigate the treatment effect of aspirin and clopidogrel dual antiplatelet therapy combined with butylphthalide and sodium chloride injection on sleep disorders in patients with progressive cerebral infarction and the influence on sleep structure, and to providing the basis for reducing the progressive risk of cerebral infarction. Methods A total of 206 patients who were hospitalized in the department of Neurology of the Second Hospital of Baoding from April 2013 to December 2015 were sampled in accordance with the progressive cerebral infarction associated with sleep disorder. The samples were randomly divided into treatment group including 103 cases （treated with butylphthalide and sodium chloride injection） and control group with another 103 cases without treatment. The onset time of the patients was within 48 hours, PSQI ≥ 8. Grading for PSQI, NIHSS, Barthel scores were recoeded before the treatment, and after the treatment on the day 8, 15 and 30. All patients were monitored through polysomnography on the day 1 and 30. All the data including PSQI, NIHSS, Barthel scores, sleep structure and process index were recorded, compared and analyzed. Results There were significant differences （P〈 0.05） between the treatment group on day 15 and day 30 after treatment. Compared with the control group, and with the same group before treatment, the PSQI, NIHSS score and Barthel score in the treatment group had significant differences （P 〈 0.05）. After the 30-day treatment, compared with the control group, the total sleep time, sleep efficiency, deep sleep ratio, and the ratio of REM phase were all significantly increased. The sleep latency, sleep apnea, nighttime awakenings and the apnea hypopnea index （P 〈 0.05） were significantly decreased in the treatment group. Conclusions Bntylphthalide and sodium chloride injection combined together with aspirin and clopidogrel can effectively intervene in the progress of sleep disorder after cerebral infarction and improve the sleep structure.
出处
《中国现代医学杂志》
CAS
北大核心
2017年第8期103-108,共6页
China Journal of Modern Medicine
