| Objective:Retrospective analysis was conducted to explore the risk factors of patients with acute phase post-stroke depression(PSD)complicated with sleep disorders,and to analyze the clinical characteristics of patients with acute phase PSD complicated with sleep disorders,so as to provide theoretical basis for early clinical detection of acute phase PSD complicated with sleep disorders,intervention of its risk factors and relevant diagnosis and treatment.Methods:According to the diagnostic criteria of post-stroke depression and sleep disorder,the acute phase stroke patients included in the study were divided into the disease group(patients with acute phase PSD complicated sleep disorders)and the control group(patients without either depression or sleep disorders).Basic data,imaging data,neuropsychological scale and other data of patients in the two groups were collected to analyze the risk factors of the disease,analyze the characteristics of the diseases associated with stroke,and evaluate the sleep characteristics of patients in the disease group and the correlation between depression and sleep disorder.Results:1.The data of 105 patients showed that there were significant differences in the past disease history of the disease group,including hypertension(P < 0.001),coronary heart disease(P = 0.002),diabetes history(P < 0.001),smoking history(P < 0.001),drinking history(P < 0.001),hyperlipidemia(P < 0.001)and hyperhomocysteinemia(P <0.001)compared with the control group.2.Among the stroke characteristics,there was no significant difference in stroke liability vascular system between the disease group and the control group(P=0.612).Compared with the control group,the patients in the disease group had significant differences in whether the stroke was involved in the dominant hemisphere(P < 0.001),imaging Aspect score(P < 0.001),severity of neurological deficit: NHISS score(P < 0.001),m RS score(P = 0.003),and impairment of life ability after stroke: ADL score after stroke(P < 0.001).3.By Logistic regression analysis,excluding the influence of mixed factors,hyperlipidemia,affected dominant hemisphere,imaging Aspect score,NHISS score were closely related to the occurrence of acute phase PSD complicated with sleep disorders(P = 0.036,0.008,0.009,0.037).4.Analysis of sleep characteristics of patients with acute phase PSD complicated with sleep disorders:total sleep time(5.50 ± 0.46 hours),lower than the reference value(7.0-8.0 hours);sleep efficiency(85.38 ± 3.56%),lower than the reference value(90-100%);initial sleeping time(0.81 ± 0.23 hours),higher than the reference value(0-0.5 hours);awakening time(1.44 ± 0.67 hours),higher than the reference value(0-0.4 hours);REM Period time(0.81 ± 0.30 hours),lower than the reference value(1.4-1.9hours).There was a positive correlation between the severity of depression(SDS score)and the severity of sleep disorders(PSQI total score)(rs = 0.855,P < 0.001).Conclusion:1.Hypertension,coronary heart disease,diabetes history,smoking history,drinking history,hyperlipidemia,hyperhomocysteinemia are the risk factors of acute phase PSD complicated sleep disorders.2.The occurrence of acute phase PSD complicated sleep disorders is related to whether the dominant hemisphere is involved,the severity of neurological deficit,and the degree of impairment of living ability.Moreover,stroke in the dominant hemisphere,severe neurological deficit,and severe impairment of living ability are more likely to occur.3.Hyperlipidemia,affected dominant hemisphere,imaging aspect score and nhiss score were independent risk factors of acute phase PSD complicated sleep disorders.4.The sleep characteristics of acute phase PSD complicated sleep disorders are as follows: the total sleep time is shortened,the initial sleeping time is prolonged,the awakening time is prolonged,the REM period is shortened,and the sleep efficiency is reduced.And the severity of depression is related to the severity of sleep disorders. |
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