基于烟雾病慢性脑缺血患者主观睡眠质量的影响因素分析OA北大核心CSTPCD

Objective To explore the sleep quality and influencing factors in patients with chronic cerebral ischemia represented by Moyamoya disease without stroke,and analyze the correlation between sleep quality and postoperative ischemic symptoms and stroke. Methods A total of 138 Moyamoya disease patients without stroke confirmed by imaging were prospectively included,and clinical data including gender,age,initial symptoms,and comorbidities were collected.The Pittsburgh sleep quality index scale was used to assess the patient's preoperative sleep quality,and the HAMD-17 and MoCA were used to evaluate preoperative depression status and cognitive function,respectively.Clinical characteristics,cognitive function,and depression status were compared between the normal sleep quality group and the decreased sleep quality group.Multivariate logistic regression analysis was used to analyze the risk factors affecting patient's sleep quality.Patients who underwent cerebral revascularization were followed up to determine the differences in the incidence of postoperative ischemic events and stroke between the normal and decreased sleep quality groups. Results A total of 52(37.7％)patients with Moyamoya disease experienced decreased sleep quality.Patients with decreased sleep quality were older(P=0.002),had poorer cognitive function(P=0.017),and exhibited more significant depressive tendencies(P=0.012)than those with normal sleep quality.Multivariate analysis suggested that age(OR 1.05,95％CI 1.01-1.09,P=0.021)and HAMD-17 score(OR 1.11,95％CI 1.01-1.23,P=0.035)were independent risk factors for decreased sleep quality.Additionally,during the postoperative follow-up,patients with a preoperative decrease in sleep quality had a higher incidence of ischemic symptoms(P=0.008).There was no significant difference in stroke recurrence rates between the two groups. Conclusions Patients with Moyamoya disease without stroke have a higher proportion of sleep disorders,which are associated with postoperative ischemic events,highlighting the need for enhanced assessment and intervention of sleep quality in clinical practice.