Zhang Yajing, Xia Xiaoshuang, Zhang Ting, Zhang Chao, Liu Ran, Yang Yun, Liu Shuling, Li Xin, Yue Wei
Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Front Aging Neurosci. 2023 Jul 21;15:1036994. doi: 10.3389/fnagi.2023.1036994. eCollection 2023.
To investigate the effects of sleep disorders on post-stroke cognitive impairment (PSCI) and other factors affecting post-stroke cognitive impairment.
A total of 1,542 first-ever stroke inpatients in department of neurology of Tianjin Huanhu Hospital from 2015.6.1 to 2016.12.31. We recorded the personal history of patients. The MMSE (mini-mental state examination), MoCA (Montreal Cognitive Assessment), HAMD (Hamilton Depression Scale), BI (Barthel index), mRS (Modified Rankin Scale), PSQI (Pittsburgh Sleep Quality Index), ESS (Epworth Sleepiness Scale), Berlin questionnaire, nocturnal TST (total sleep time) were assessed before discharge. All patients were followed up at 3 months, 6 months, and 4 years (2019-2020) after stroke. During follow-up, the above scales should be evaluated again to assess the sleep status and cognitive function of patients at that time.
Nocturnal TST (>8 h) (OR 3.540, 95% CI 1.692-7.406, = 0.001) was a risk factor for cognitive impairment 3 months after stroke. Nocturnal TST (<7 h) (OR 6.504, 95% CI 3.404-12.427, < 0.001) was a risk factor for cognitive impairment 6 months after stroke. Low sleep quality (OR 2.079, 95% CI 1.177-3.672, = 0.012), sleepiness (OR 3.988, 95% CI 1.804-8.818, = 0.001), nocturnal TST (<7 h) (OR 11.334, 95% CI 6.365-20.183, < 0.001), nocturnal TST (>8 h) (OR 4.096, 95% CI 1.682-9.975, = 0.002) were risk factors for cognitive impairment 4 years after stroke. The prevalence of cognitive impairment with TIA were 79.3% at admission, 68.1% at 3-months follow-up, 62.1% at 6-months follow-up and 52.2% at 4-year follow-up.
Long or short nocturnal TST (<7 h or >8 h) was a risk factor for cognitive impairment after stroke (3 months, 6 months and 4 years). Poor sleep quality and sleepiness were shown to be risk factors for cognitive impairment at 4-year follow-up. Cognitive impairment was very common in patients with TIA.
探讨睡眠障碍对卒中后认知障碍（PSCI）的影响以及其他影响卒中后认知障碍的因素。
选取2015年6月1日至2016年12月31日在天津环湖医院神经内科住院的1542例首次发生卒中的患者。记录患者的个人史。在出院前评估简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、汉密尔顿抑郁量表（HAMD）、巴氏指数（BI）、改良Rankin量表（mRS）、匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表（ESS）、柏林问卷、夜间总睡眠时间（TST）。所有患者在卒中后3个月、6个月和4年（2019 - 2020年）进行随访。在随访期间，应再次评估上述量表，以评估患者当时的睡眠状况和认知功能。
夜间TST（>8小时）（OR 3.540，95%CI 1.692 - 7.406，P = 0.001）是卒中后3个月认知障碍的危险因素。夜间TST（<7小时）（OR 6.504，95%CI 3.404 - 12.427，P < 0.001）是卒中后6个月认知障碍的危险因素。睡眠质量差（OR 2.079，95%CI 1.177 - 3.672，P = 0.012）、嗜睡（OR 3.988，95%CI 1.804 - 8.818，P = 0.001）、夜间TST（<7小时）（OR 11.334，95%CI 6.365 - 20.183，P < 0.001）、夜间TST（>8小时）（OR 4.096，95%CI 1.682 - 9.975，P = 0.002）是卒中后4年认知障碍的危险因素。短暂性脑缺血发作（TIA）患者认知障碍的患病率在入院时为79.3%，3个月随访时为68.1%，6个月随访时为62.1%，4年随访时为52.2%。
夜间TST过长或过短（<7小时或>8小时）是卒中后（3个月、6个月和4年）认知障碍的危险因素。睡眠质量差和嗜睡在4年随访时被证明是认知障碍的危险因素。认知障碍在TIA患者中非常常见。
