摘要
目的探讨脑卒中后睡眠障碍患者血清神经元特异性烯醇化酶(NSE)、白细胞介素-1β(IL-1β)及5-羟色胺(5-HT)水平的变化及意义。方法选取200例脑卒中患者为研究对象,根据匹斯堡睡眠质量指数(PSQI)评分分为睡眠障碍组(SD组,PSQI评分7~14分)和无睡眠障碍组(non-SD组,PSQI评分15~21分)。对比2组血清NSE、IL-1β、5-HT水平,探讨血清NSE、IL-1β、5-HT表达情况与脑卒中后睡眠障碍的关系。结果200例脑卒中患者中出现睡眠障碍56例,发生率为28.00%。SD组患者血清NSE、IL-1β水平及NIHSS评分均显著高于non-SD组(t=7.880、9.405、5.814,P<0.05),而SD组血清5-HT水平低于non-SD组(t=8.789,P<0.05)。随着睡眠障碍程度的加重,患者血清NSE、IL-1β水平明显升高(t=4.184、3.774,P<0.05),而血清5-HT水平降低(t=3.167,P<0.05)。睡眠障碍患者血清NSE、IL-1β水平与PSQI评分呈显著正相关(r=0.341、0.363,P<0.05),而血清5-HT水平与PSQI评分呈负相关(r=0.438,P<0.05)。Logistic回归分析显示,NIHSS评分高(OR=1.367,95%CI 1.018~1.835,P<0.05)、血清NSE(OR=1.386,95%CI 1.120~1.716,P<0.05)与IL-1β(OR=1.149,95%CI 1.063~1.243,P<0.05)高表达及血清5-HT(OR=0.770,95%CI 0.667~0.889,P<0.05)低表达是脑卒中后睡眠障碍的危险因素(P<0.05)。结论脑卒中后睡眠障碍的发生率较高,神经递质分泌失调和炎症反应是导致脑卒中后睡眠障碍的重要原因。
Objective To investigate the changes of neuron-specific enolase(NSE),interleukin-1β(IL-1β)and 5-hydroxy⁃tryptamine(5-HT)levels in patients with post-stroke sleep disorder and its significance.Methods A total of 200 stroke patients were selected as study subjects.According to the Pittsburgh sleep quality index(PSQI)score,the patients were divided into the sleep disor⁃der group(SD group,PSQI score 7-14)and the non-sleep disorder group(non-SD group,PSQI score 15-21).The differences in levels of serum NSE,IL-1βand 5-HT were compared between the two groups,and the relationship between the expression of serum NSE,IL-1βand 5-HT and sleep disorders after stroke were investigated.Results Sleep disturbance occurred in 56 of the 200 stroke pa⁃tients,with an incidence of 28.00%.Serum NSE,IL-1βlevels and NIHSS scores of SD group were significantly higher than those of non-SD group(t=7.880,9.405,5.814,P<0.05),while serum 5-HT level of SD group was lower than that of non-SD group(t=8.789,P<0.05).With the severity of sleep disturbance,serum NSE and IL-1βlevels were significantly increased(t=4.184,3.774,P<0.05),while serum 5-HT levels were decreased(t=3.167,P<0.05).The serum NSE and IL-1βlevels were significantly positively correlated with PSQI score(r=0.341,0.363,P<0.05),while serum 5-HT levels were positively correlated with PSQI score(r=0.438,P<0.05).Logistic regression showed that high NIHSS score(OR=1.367,95%CI 1.018-1.835,P<0.05),high serum NSE(OR=1.386,95%CI 1.120-1.716,P<0.05),IL-1β(OR=1.149,95%CI 1.063-1.243,P<0.05)expression,and low serum 5-HT(OR=0.770,95%CI 0.667-0.889,P<0.05)expression were risk factors for sleep disorders after stroke(P<0.05).Conclusion The incidence of sleep disor⁃ders after stroke is high,and the imbalance of neurotransmitter secretion and inflammatory response are the important causes of sleep dis⁃orders after stroke.
作者
王苇
周汝宁
郝丽丽
WANG Wei;ZHOU Runing;HAO Lili(Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《中国实用神经疾病杂志》
2021年第8期714-719,共6页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20190284)。
