目的 分析研究不同类型脑梗死患者睡眠结构及其与抑郁的相关性,为脑梗死患者睡眠障碍及抑郁的治疗提供新的思路及理论支持。方法 抽取我院2012年4月—2015年5月接收的124例脑梗死患者进行分组研究,根据脑梗死不同发生部位将患者分为四组,分别为小脑梗死组30例、皮层梗死组33例、脑干梗死组29例及皮层下梗死组32例,对比观察四组患者睡眠结构及睡眠参数和睡眠障碍、HAMD评分的相关性。结果 四组患者睡眠结构相比存在明显差异,脑干梗死组和皮层下梗死组觉醒时间远多于小脑梗死组和皮层梗死组,小脑梗死组NREM 1+2期、NREM期明显短于皮层梗死组、脑干梗死组及皮层下梗死组,小脑梗死组REM期、NREM 3+4期明显大于皮层梗死组、脑干梗死组及皮层下梗死组,各项数据对比差异均有统计学意义(P＜0.05);HAMD评分、PSQI评分和NREM1+2期、觉醒指数呈正相关关系(P＜0.05,r＞0);与REM期和NREM 3+4期呈负相关关系(P＜0.05,r＜0)。结论 皮层下梗死睡眠结构紊乱发生率更高,并且睡眠结构的变化和脑梗死后抑郁评分、睡眠障碍评分具有一定关系。

Objective To study the correlation between sleep structure and depression in patients with different types of cerebral infarction,to provide new ideas and theoretical support for the treatment of sleep disorders and depression in patients with cerebral infarction. Methods 124 patients with cerebral infarction in our hospital from April 2012 to May 2015 were selected. They were divided into four groups according to the different parts of the cerebral infarction, respectively, 30 cases of cerebellar infarction group, 33 cases of cortical infarction group, 29 cases of brainstem infarction group and 32 cases of subcortical infarction group. The correlation of sleep structure and sleep parameters, sleep disorder and HAMD score of the four groups were observed and compared. Results There was a significant difference in sleep structure between the four groups. Brainstem infarction group and subcortical infarction group awakening time was far more than that of cerebellar infarction group and cortex infarction group.Cerebellar infarction group NREM 1+2, NREM period was significantly shorter in cortical infarction, brain stem infarction group and subcortical infarction group. Cerebellar infarction group of REM and NREM stage 3+4 were significantly greater than that of cortical infarction death group, brain stem infarction group and cerebral cortex infarction group. The differences were statistically significant(P<0.05);HAMD score, PSQI score and NREM1+2 period, arousal index was positively correlated (P<0.05, r> 0); And REM phase and 3+4 NREM phase was negatively correlated (P<0.05, r< 0). Conclusion Subcortical infarction sleep structure disorder incidence is higher, and the sleep structure changes and infarction depression score, sleep disorder score has a certain relationship.

目的 研究血浆脂蛋白磷脂酶 A2(Lp-PLA2)在防治急性动脉硬化性脑梗死中的临床价值。方法 选取2014年1月—2015年12月在我院经头颅MRI+MRA及脑血管造影确诊为急性动脉硬化性脑梗死患者80例为病例组,选取同期来我院例行体检头MRI+MRA 正常的健康自愿者40名为对照组。病例组采取脑梗死规范治疗及肢体功能康复锻炼,以酶联免疫法分不同时段测定两组患者血浆Lp-PLA2的浓度,以及评价病例组神经功能缺损程度,经数据分析研究脑梗死患者血浆Lp-PLA2浓度与神经功能缺损程度相关性。结果 急性动脉硬化性脑梗死患者血浆 Lp-PLA2浓度高于健康对照组患者,经统计学分析,P<0.05,并且随着脑梗死时间的推移,Lp-PLA2浓度愈低。NIHSS评分显示,随着脑梗死时间推移,NIHSS评分越来越低,差异有统计学意义(P<0.05)。对比同时期NIHSS评分和患者 Lp-PLA2浓度,NIHSS与Lp-PLA2浓度呈正相关(r=2.376,P<0.01)。结论 血浆Lp-PLA2 浓度升高是脑梗死的危险因素之一,降低血浆 Lp-PLA2 浓度可在脑梗死的早期预防上起到积极作用。

Objective To explore clinical value of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in controlling acute atherosclerosis cerebral infarction. Methods 80 cases of acute atherosclerosis patients diagnosed by head MRI+MRA were selected as cases group, and 40 as normal controls. Cases treated with cerebral infarction specification therapy and lib function rehabilitation exercise. Using enzyme-linked immunoassay points at different times of measuring the concentration of plasma Lp-PLA2 in both groups, evaluating nerve function defect degree of cases, then analysis the correlation of cerebral infarction plasma concentration of Lp-PLA2 and neural function defect degree. Results Acute atherosclerotic cerebral infarction patients plasma concentration of Lp-PLA2 patients was significantly higher than healthy control group, by statistics analysis P<0.05, and with cerebral infarction time went by, the Lp-PLA2 concentration was lower. NIHSS score, with the time of cerebral infarction passed, was lower and lower, the change was statistically significant P<0.05.Compared with NIHSS score and concentration of Lp-PLA2, NIHSS and Lp- PLA2 concentration were positively correlated, r=2.376,P<0.01. Conclusion Plasma Lp-PLA2 is a risk factor for cerebral infarction. Reducing plasma concentration of Lp-PLA2 can play a positive role on the early prevention of cerebral infarction.