Preliminary clinical analysis for acute cerebral infarction with periodic limb movements
10.3969/j.issn.1672-5921.2020.05.002
- Author:
Junying HUANG
1
Author Information
1. Department of Neurology, Second Affiliated Hospital of Soochow University
- Publication Type:Journal Article
- Keywords:
Acute cerebral infarction;
Periodic limb movements during sleep;
Sleep disorders
- From:
Chinese Journal of Cerebrovascular Diseases
2020;17(5):231-236
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical features of patients with acute cerebral infarction combined with periodic limb movements during sleep (PLMS). Methods A total of 170 continuous patients with acute cerebral infarction in the Department of Neurology of the Second Affiliated Hospital of Soochow University from February 2016 to June 2018 was enrolled prospectively, including 102 males (60. 0%) and 68 females(40. 0%). Those patients were divided into non-PLMS group (period limb movement index[PLMI] <5 times/hour) and PLMS group (PLMI ≥5 times/hour) according to the PLMI. Physical activity recorder monitoring and head magnetic resonance imaging were performed within 2 weeks of onset. The baseline National Institutes of Health Stroke Scale(NIHSS) scores, previous medical history (including hypertension, diabetes, atrial fibrillation, coronary heart disease, hyperlipidemia), smoking history, stroke classification of the Oxfordshire Community Stroke Project(OCSP), biochemistry indicators (glycated hemoglobin, creatinine, homocysteine, total cholesterol, low-density lipoprotein), and sleep parameters were recorded and compared between both groups. The modified Rankin Scale (mRS) score was used to evaluate the recovery of neurological function at 3, 6, and 12 months, and the Barthel index was used to assess the self-care ability of daily life at 12 months. PLMI ≥5 times/h was defined as PLMS. Results (1) The proportion of patients with acute cerebral infarction combined with PLMS was 61.2% (104/170). The proportion of previous stroke history in the non-PLMS group was lower than that in the PLMS group, which was statistically significant (24.2% [16/66] vs. 39.4% [41/104], χ2=3.866, P = 0.049). There were insignificant in age, gender, smoking history, hypertension, diabetes, atrial fibrillation and NIHSS scores between two groups (all P > 0. 05). (2) In the non-PLMS group, the proportion of partial anterior circulation infarction was the highest (34. 8%, 23/66), and the proportion of complete anterior circulation infarction was the lowest (10. 6%, 7/66). In the PLMS group, the proportion of lacunar infarction was the highest (36.5 %, 38/104), and the proportion of complete anterior circulation infarction was the lowest (8.7%, 9/104). There was statistically significant in stroke classification of OCSP between the two groups (χ2=12.528, P=0.006), but insignificant in fasting blood glucose, glycated hemoglobin, creatinine, homocysteine, total cholesterol and low-density lipoprotein levels between the two groups (both P > 0. 05). (3) The proportion of awakening, awakening time, and the number of awakenings in the non-PLMS group were all lower than those in the PLMS group, which were statistically significant (6.0[3.0, 8.0] vs. 12.0[7. 0, 19.0], 3.0[1.5, 4.2] min vs. 4.4[3.0, 6.0] min and 18.5[7.0, 33.8] times vs.50.0[28.0, 84.0] times, the Z values were -6.046, -3.922 and -6.8789, all P < 0.01). Sleep efficiency and total sleep time were higher in the non-PLMS group than those in PLMS group, which were statistically significant (96. 6% [93. 6%, 98. 7%] vs. 91. 0% [84. 6%, 93. 9%], 497.0[470.0, 529.8]minus. 489.0[447.0, 507.0]min, and the Z values were -6.586 and -2.503 respectively, all P < 0. 01). (4) There was insignificant in the rate of good prognosis at 3, 6, and 12 months, and Barthel index at 12 months after onset between both groups (all P > 0. 05). Conclusions Patients with acute cerebral infarction have a high proportion of PLMS in the acute phase. There is a high proportion of lacunar infarction and sleep fragmentation in patients with acute cerebral infarction combined with PLMS.
