Association of baseline cerebral blood flow and cerebral metabolic rate of oxygen with sleep structure disorder after thrombolytic therapy in stroke patients and their value in clinical assessment
10.19845/j.cnki.zfysjjbzz.2026.0057
- VernacularTitle:基线脑血流量和脑氧代谢率与脑卒中患者溶栓治疗后睡眠结构紊乱的关联及其临床评估价值
- Author:
Xiangcheng LI
1
;
Yihua HE
2
Author Information
1. Department of Neurology， The Third People’s Hospital of Chenzhou City， Chenzhou 423000， China
2. Department of Neurology， Nanfang Hospital， Southern Medical University， Guangzhou 510515， China
- Publication Type:Journal Article
- Keywords:
Stroke;
Thrombolysis;
Cerebral blood flow;
Cerebral metabolic rate of oxygen;
Clinical assessment value
- MeSH:
Stroke
- From:
Journal of Apoplexy and Nervous Diseases
2026;43(4):332-337
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association of baseline cerebral blood flow （CBF） and cerebral metabolic rate of oxygen （CMRO2） with sleep structure disorder after thrombolytic therapy in stroke patients， as well as their value in clinical assessment. Methods A total of 145 patients with stroke were enrolled as subjects， and all of them received thrombolytic therapy in our hospital from January 2023 to June 2025. Before thrombolytic therapy， 3.0 T magnetic resonance imaging was used to obtain relative CBF （rCBF） and relative CMRO2 （rCMRO2）， and rCBF/rCMRO2 ratio was calculated. At week 1 after thrombolysis， overnight polysomnography （PSG） was conducted to obtain parameters such as total sleep time， sleep efficiency， the proportion of each NREM stage， and REM sleep duration. According to the presence or absence of sleep structure disorder， the subjects were divided into disorder group and non-disorder group. The Pearson correlation method was used for correlation analysis. A multivariate logistic regression analysis was used to identify the influencing factors for sleep structure disorder in subjects after thrombolytic therapy. The receiver operating characteristic （ROC） curve was plotted to analyze the performance of rCBF/rCMRO2 ratio in predicting sleep structure disorder in subjects after thrombolytic therapy. Results Compared with the non-disorder group， the disorder group had significantly higher age， infarct volume， NIHSS score on admission， and proportion of patients with infarction in the thalamus （P<0.05）. Compared with the non-disorder group， the disorder group had significantly lower rCBF， rCMRO2， rCBF/rCMRO2 ratio， total sleep time， proportion of NREM 3 sleep， proportion of REM sleep， and sleep efficiency （P<0.05） and significantly higher proportion of NREM 1 sleep and sleep arousal index （P<0.05）. The Pearson correlation analysis showed that rCBF， rCMRO2， and rCBF/rCMRO2 ratio were positively correlated with total sleep time， proportion of NREM 3 sleep， proportion of REM sleep， and sleep efficiency （P<0.001） and were negatively correlated with the proportion of NREM 1 sleep and sleep arousal index （P<0.001）. The Logistic regression analysis showed that age， infarct volume， infarction location （thalamus）， and NIHSS score on admission were risk factors for sleep structure disorder in stroke patients after thrombolytic therapy （P<0.05）， while rCBF， rCMRO2， and rCBF/rCMRO2 ratio were protective factors against sleep structure disorder （P<0.05）. The ROC curve analysis showed that rCBF/rCMRO2 ratio had an area under the ROC curve of 0.901 （95% CI 0.869-0.938） in predicting sleep structure disorder in stroke patients after thrombolytic therapy， with a sensitivity of 95.50% and a specificity of 82.40%. Conclusion Baseline rCBF， rCMRO2， and rCBF/rCMRO2 ratio are closely associated with sleep structure disorder in stroke patients after thrombolytic therapy， among which rCBF/rCMRO2 ratio has excellent performance in predicting sleep structure disorder and can be used as a sensitive indicator for clinical assessment of high-risk patients.
- Full text:2026061214214153498基线脑血流量和脑氧代谢率与脑卒中患者溶栓治疗后睡眠结构紊乱的关联及其临床评估价值.pdf
