Analysis Of Related Factors Of Neurological Dysfunction In Acute Ischemic Stroke

Objective:This study was aimed to investigate sleep disorders before and after acute ischemic stroke and analyze the related factors affecting the prognosis of acute ischemic stroke.Methods:1.Consecutively enrolled onset within 48 hours of ischemic stroke hospitalized patients in Beijing Haidian hospital during 2015 June 1st to September 1st,data were collected including demographics,comorbidities,and the stroke of risk factors.At the same time,collected 1 months before admission,the state of sleep,namely:sleep duration,PSQI,ESS,AIS and Berlin questionnaire.NIHSS,PSQI,ESS,lesions,and AIS were collected at admission.2.Followed up the 14th day of neurological deficit,that is NIHSS of the 14th day.3.DeltaNIHSS is result of NIHSS on admission minus N1HSS of the 14th day.4.Multivariate and univariate regression model were used to analyze the related factors of neurological dysfunction in acute ischemic stroke.Results:1.Before the onset of acute ischemic stroke,the average ESS was 3.32±4.17,the average AIS was 3.79±3.94,the average PSQI was 4.80±4.07,the prevalence of drowsiness was 21.7%,the prevalence of insomnia was 22.6%,the prevalence of extremely poor sleep quality was 2.8%.After the onset of acute ischemic stroke,the average ESS was 8.84±7.19,the average AIS was 9.32±5.85,the average PSQI was 8.11± 5.12,the prevalence of drowsiness was 57.5%,the prevalence of insomnia was 61.2%,the prevalence of extremely poor sleep quality was 10.4%.2.Pearson correlation analysis showed that premorbid ESS and NIHSS on admission were related(r=0.199,P = 0.041).Premorbid ESS and NIHSS of the 14th day were related(r=0.276,P = 0.004);ESS on admission and NIHSS of the 14th day were related(r = 0.450,P = 0.000).3.Logistic regression analysis showed that age(OR = 0.052,95%CI 1.006?1.104,P=0.028),atrial fibrillation(OR 2.301,95%CI 1.071-93.074 P=0.043)and anterior circulation lesions(OR-1.783,95%CI 0.034?0.830,P=0.029)were independent risk factors for NIHSS on admission.4 Logestic regression analysis showed that NIHSS on admission(OR 2.455,1.586?3.801 95%CI,P=0.000)was the independent risk factor for NIHSS of the 14th day.5 Logestic regression analysis showed that Berlin questionnaire(+)(OR 0.299,0.115?0.779 95%CI,P=0.013)was the independent risk factor for neurological deterioration in acute ischemic stroke.Conclusion:(1)Ischemic stroke can lead to sleep disorders.The prevalence of drowsiness,insomnia and poor sleep quality are all increased.(2)Premorbid drowsiness is related to neurological dysfunction.Premorbid drowsiness is related to NIHSS of the 14th day.Patients who were sleepy before and after the onset of ischemic stroke tend to have more seriously neurological dysfunction.(3)The age,atrial fibrillation and anterior circulation lesion are independent risk factors of NIHSS NIHSS ? 6,while the older patients,who have history atrial fibrillation and anterior circulation lesions are more seriously.(4)The more seriously neurological dysfunction on admission,the more seriously neurological dysfunction of 14 days.(5)Patients who are Berlin questionnaire(+)tend to deteriorate in acute stage.So we should positively screen for SDB in ischemic stroke patients and give Interventions of acute ischemic stroke patients with SDB disease to prevent deterioration.SAHS,obesity and hypertension are the possible independent risk factors led to the recurrence of non-cardiac ischemic stroke.