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首次缺血性卒中急性期疲劳的决定因素。

Determinants of fatigue after first-ever ischemic stroke during acute phase.

作者信息

Wang Shan-Shan, Wang Jia-Ji, Wang Pei-Xi, Chen Ruoling

机构信息

Institute of Public Health, School of Nursing, Henan University, Kaifeng, China.

Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.

出版信息

PLoS One. 2014 Oct 10;9(10):e110037. doi: 10.1371/journal.pone.0110037. eCollection 2014.

Abstract

BACKGROUND AND PURPOSE

Fatigue after stroke is common and has a negative impact on rehabilitation and survival. However, its pathogenesis and contributing factors remain unclear. The purpose of this study was to identify factors influencing the occurrence of fatigue after first-ever ischemic stroke in acute phase.

METHODS

We examined 265 consecutive patients with first-ever ischemic stroke during acute phase (within 2 weeks) in two tertiary stroke care hospitals in Henan, China. We documented patients' demographic and clinical characteristics through face-to-face interviews using structured questionnaires and reviews of medical records. Post-stroke fatigue was defined as a score of ≥4 using the Fatigue Severity Scale. Multivariate logistic regression was used to examine post-stroke fatigue in relation to socio-demographic, lifestyle, clinical characteristics and family function.

RESULTS

About 40% first-ever ischemic stroke patients experienced post-stroke fatigue in acute phase. Post-stroke fatigue was associated with lack of exercise before stroke (adjusted odds ratio 4.01, 95% CI 1.95-8.24), family dysfunction (2.63, 1.20-5.80), depression (2.39, 1.02-5.58), the presence of pre-stroke fatigue (4.89, 2.13-11.21), use of sedative medications (4.14, 1.58-10.88), coronary heart disease (3.38, 1.46-7.79) and more severe Modified Rankin Scale (2.55, 1.65-3.95).

CONCLUSIONS

The causes of post-stroke fatigue are multifaceted. More physical exercise, improving family function, reducing depression and appropriate use of sedative medications may be helpful in preventing post-stroke fatigue.

摘要

背景与目的

卒中后疲劳很常见,对康复和生存有负面影响。然而,其发病机制和影响因素仍不清楚。本研究的目的是确定影响首次急性缺血性卒中后疲劳发生的因素。

方法

我们在中国河南的两家三级卒中护理医院检查了265例连续的首次急性缺血性卒中患者(发病2周内)。我们通过使用结构化问卷进行面对面访谈和查阅病历记录患者的人口统计学和临床特征。卒中后疲劳定义为使用疲劳严重程度量表得分≥4分。采用多因素逻辑回归分析卒中后疲劳与社会人口学、生活方式、临床特征和家庭功能的关系。

结果

约40%的首次缺血性卒中患者在急性期经历了卒中后疲劳。卒中后疲劳与卒中前缺乏运动(调整比值比4.01,95%可信区间1.95-8.24)、家庭功能障碍(2.63,1.20-5.80)、抑郁(2.39,1.02-5.58)、卒中前存在疲劳(4.89,2.13-11.21)、使用镇静药物(4.14,1.58-10.88)、冠心病(3.38,1.46-7.79)以及更严重的改良Rankin量表评分(2.55,1.65-3.95)有关。

结论

卒中后疲劳的原因是多方面的。更多的体育锻炼、改善家庭功能、减轻抑郁以及合理使用镇静药物可能有助于预防卒中后疲劳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51a2/4193856/7808de8ef2ae/pone.0110037.g001.jpg

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