摘要
Abstract
Objective To explore the influencing factors of post-stroke sleep disorders in patients with minor ischemic stroke(MIS)in moderate-to-high altitude areas,focusing on the interaction between the high-altitude hypoxic environment and hematocrit(HCT),stroke lesion location,as well as post-stroke anxiety and depression.
Methods A retrospective cohort design was adopted,with data derived from the Qinghai Provincial People's Hospital sub-center database of the China national stroke registry-Ⅲ from October 2016 to July 2019.The Pittsburgh sleep quality index(PSQI)was used to assess sleep quality of the MIS patients at 6 weeks after stroke,with a total PSQI score≥7 defined as post-stroke sleep disorder.By integrating data from neuroimaging,hemorheological indicators,and scores of psychological assessment scales,multivariate logistic regression analysis was used to identify independent risk factors for post-stroke sleep disorders.The predictive efficacy of HCT was evaluated using ROC curves.
Results A total of 152 MIS patients were included,and the incidence of post-stroke sleep disorders was 54.6％(83/152).Multivariate logistic regression analysis showed that permanent residence at an altitude≥3000 meters(OR4.550,95％CI2.499-4.588,P=0.011),posterior circulation infarction(OR2.089,95％CI1.961-4.762,P=0.042),HCT≥55％(OR8.545,95％CI4.708-15.500,P=0.001),and post-stroke depression(OR1.991,95％CI1.082-3.660,P=0.048)were independent risk factors for post-stroke sleep disorders.ROC curve analysis revealed that the AUC of HCT for predicting post-stroke sleep disorders was 0.731(95％CI0.630-0.833,P=0.009),with the optimal cut-offvalue of 55.5％,corresponding to a sensitivity of 0.806 and a specificity of 0.634.
Conclusions The incidence of post-stroke sleep disorders is relatively high in MIS patients in moderate-to-high altitude areas.Permanent residence at an altitude≥3000 meters,posterior circulation infarction,HCT≥55％,and post-stroke depression are important influencing factors.Integrating the above indicators is conducive to the early identification of high-risk populations and provides a basis for formulating plateau-specific sleep management strategies.关键词
中高海拔地区/轻型缺血性卒中/睡眠障碍/卒中后抑郁/红细胞压积Key words
Moderate-to-high altitude area/Minor ischemic stroke/Sleep disorder/Post-stroke depression/Hematocrit分类
医药卫生
