伴有与不伴有主观失眠的急性心肌梗死患者相关因素分析

摘要/Abstract

摘要： 目的分析伴有与不伴有主观失眠的急性心肌梗死（AMI）患者相关因素特点。方法选取2019年1月至2020年10月期间就诊于福建省立医院心内科住院部并诊断为急性心肌梗死的患者共166例,其中82例伴有主观失眠的急性心肌梗死患者作为实验组,不伴有主观失眠者的急性心肌梗死患者84例作为对照组。收集患者一般资料,记录患者入院第二日晨起血液中的血清肌钙蛋白I（cTnI）、N端-B型钠尿肽前体（NT-proBNP）、总胆固醇（TC）等资料;并采用匹兹堡睡眠质量量表（PSQI）、焦虑自评量表（SAS）、抑郁自评量表（SDS）对两组患者的睡眠、情绪因素进行分析。结果两组伴有与不伴有主观失眠的急性心肌梗死患者中,存在主观失眠者的年龄明显高于对照组（P<0.001）;但两组患者在性别、吸烟史、饮酒史、既往疾病史（高血压、糖尿病）方面均无显著差异（P>0.05）;两组患者间cTnI、NT-proBNP、TC比较也无显著差异（P>0.05）;而两组患者中焦虑、抑郁情绪却存在显著差异（P<0.001）;并且患者抑郁和焦虑情绪得分与其睡眠质量指数分数呈正相关。结论伴有主观失眠的急性心肌梗死患者的焦虑、抑郁情绪明显高于不伴有主观失眠者,且随失眠的加重其抑郁、焦虑情绪也有所增加,年龄较大的急性心肌梗死患者更易伴有主观失眠;在急性心肌梗死的治疗、康复过程中需引起关注。

关键词: 主观失眠, 急性心肌梗死, 肌钙蛋白I, N端-B型钠尿肽前体, 焦虑, 抑郁

王巍, 王热华, 张清如, 郑小星, 陈惠敏. 伴有与不伴有主观失眠的急性心肌梗死患者相关因素分析[J]. 心血管病防治知识, 2023, 13(1): 6-9.

参考文献

[1] Song C, Zhang R, Liao J, et al. Sleep quality and risk of coronary heart disease-a prospective cohort study from the English longitudinal study of ageing[J] . Aging, 2020,11(12):1-11.
[2] Javaheri S, Redline S. Insomnia and Risk of Cardiovascular Disease[J]. CHEST, 2017,152(2):435-444.
[3] Zheng B, Yu C, Lv J, et al. Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults: A 10-year cohort[J]. Neurology,2019,93:e2110-e2120.
[4] McGlinchey EL, Oyesiku L, Diaz KM,et al. Impact of Sleep Duration and Race on Recurrent Cardiovascular Events Following Acute Coronary Syndrome[J]. Journal of the American College of Cardiology,2018,71(6):701-703.
[5] Huang T, Mariani S, Redline S. Sleep Irregularity and Risk of Cardiovascular Events. Journal of the American College of Cardiology[J].2020,3,75(9):991-999.
[6] Daghlas I, Dashti HS, Lane J, et al. Sleep Duration and Myocardial Infarction[J]. Journal of the American College of Cardiology,2019,74(10):1304-1314.
[7] Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to cardiovascular health disparities[J]. Ann Rev Public Health, 2015,(36), 417-440.
[8] Bertisch SM, Pollock BD, Mittleman MA, et al. Insomnia with Objective Short Sleep Duration and Risk of Incident Cardiovascular Disease and All-Cause Mortality: Sleep Heart Health Study[J]. Sleep, 2018,41(6): zsy047.
[9] Chandola T, Ferrie JE, Perski A,et al. The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort[J].Sleep,2010,33(6):739-744.
[10] Kawada T. Sleep duration and coronary heart disease mortality[J]. International Journal of Cardiology,2016,15(215):110.
[11] Chan NY, Zhang J, Tsang CC, et al. The associations of insomnia symptoms and chronotype with daytime sleepiness, mood symptoms and suicide risk in adolescents[J].Sleep Medicine, 2020,10(74): 124-131.
[12] Koo DL, Nam H, Thomas RJ, et al. Sleep Disturbances as a Risk Factor for Stroke[J].Journal of Stroke. 2018,20(1): 12-32.
[13] Hsieh CG, Martin JL. Short Sleep, Insomnia, and Cardiovascular Disease[J]. Current Sleep Medicine Reports,2019,125(4): 234-242.
[14] Clark A, Lange T, Hallqvist J,et al. Sleep impairment and prognosis of acute myocardial infarction: a prospective cohort study[J].Sleep,2014,37(5): 851-858.
[15] Feng HQ,Zhang CH,Li YF,et al. Application value of combined detection of PCT,hs-CRP,WBC and NEU in bacterial infections in elderly patients with coronary heart disease[J]. Chinese Journal of Nosocomiology,2017,27(20):4681-4684.
[16] Willeit P, Welsh P, Evans JDW, et al. High-Sensitivity Cardiac Troponin Concentration and Risk of First-Ever Cardiovascular Outcomes in 154,052 Participants[J].Journal of the American College of Cardiology,2017,70(5): 558-568.
[17] Laar M, Pevernagie D, Mierlo P V,et al. Subjective sleep characteristics in primary insomnia versus insomnia with comorbid anxiety or mood disorder[J].Sleep and Biological Rhythms,2015,13(1):41-48.
[18] 孔悦,丁荣晶,雷莎,等. 《急性冠状动脉综合征患者失眠现况及影响因素分析》. 中华内科杂志, 2021,60(4):331-337.
[19] 孔悦.《急性冠状动脉综合征患者失眠现况及影响因素分析》[D].重庆:重庆医科大学. 2020.
[20] Janku K, Smotek M, Fárková E, et al. Subjective objective sleep discrepancy in patients with insomnia during and after cognitive behavioural therapy: An actigraphy study[J]. J Sleep Res, 2020,4(29):e13064.