The Related Clinical Research On Sleep Structure Feature And Cognitive Functions And Serum Hypocretin, IL-17in Acute Thalamic Stroke

Objective:To evaluate the sleep quality, cognitive function, memory function of acute thalamic stroke patients, test and followed their sleep structure by using Polysomnography (PSG), test the level of hypocretin and IL-17in serum, analysis the characteristic of sleep structure, cognitive function and memory function in patients of thalamic stroke and do some correlation research of them. In order to improve early recognize, diagnosis aboat the sleep disorder after thalamic stroke, we further explor the mechanism of the relationship between sleep structure and cognitive impairment of thalamic stroke.Methods:1、Collected27patients who had acute thalamic stroke as study group and13health as control in the ward or the clinic of Tianjin general hospital from March2013till March2014. All the patients had been completed some related chemical and clinical data, and all of them through cognitive function test, memory function test, sleep quality test and polysomnography test to evaluate sleep quality, sleep structure, cognitive and memory funcition in acute thalamic stroke and3months later. With above results, we analysis the change aboat these.1. the difference of sleep quality scores, sleep quality and cognitive function between thalamic stroke and the control.2. the difference aboat sleep quality and cognitive function among different parts of thalamic stroke.3. The correlation of apnea and hypopnea index and cognitive function.4. Compare of above related indicators in acute thalamic stroke and3months later.2、Collected52patients who had acute stroke and18health in the ward or the clinic of Tianjin general hospital from March2013till March2014. All of them draw venous blood after stroke within2-12days Analysis the data aboat the level of serum Hypocretin and IL-17by two methods. First, the collected can be divided into three parts according to the stroke parts, thalamic stroke, others parts stroke and the control. Second, the patients of thalamic stroke can be divided into two parts according to whether it had somnolence or not.Results: 1. Compared with control group, the sleep quality scores of Epworth, PSQI has higer trend in acute thalamic stroke, but has no statistically significant, P>0.05.2. Compared with control group, the sleep time of N1is longer and the N2, N3is shorter in thalamic stroke, the difference has statistically significance, P<0.05. Total sleep time, sleep efficiency, sleep latency, REM sleep latency, all of them had no statistically significance, P>0.05.3. Compared with sleep structure among difference parts of thalamic stroke, their had no statistically significance, P>0.05.4. Compared with control group, the scores of MMSE, MoCA, Boston, DST1were lower, and had statistically significance, P<0.05. The immediate memory score, long delay memory score of thalamic stroke group was significantly lower than the control group, the difference was statistically significant, P<0.01.5. There were correlation between cognitive function and sleep structure in thalamic stroke. MMSE has no significant relationship with it, but MoCA has negatively related with Nl, but has positively correlated with N3, P<0.05. There were correlation between cognitive function and AHI, the cognitive scores of Severe apnea has statistically significance, P<0.05.6. Compared with acute phase of thalamic stroke, the scores of MMSE. MoCA. DST2, immediate memory, delay memory were higer, and has statistically significance, P<0.05. Sleep latency, REM sleep latency were shorter than acute phase of thalamic stroke.and has statistically significance,P<0.05.7. Compared the level of hypocretin, there had statistically significance among the three groups, including thalamic stroke, orther parts stroke and the control, P<0.05. The level of hypocretin in thalamic stroke with somnolence was higer than the level of hypocretin in thalamic stroke without somnolence, and has statistically significance, P<0.01.8. Compared the level of IL-17, there had statistically significance among the three groups, including thalamic stroke, orther parts stroke and the control, P<0.05. The level of IL-17in thalamic stroke with somnolence was higer than the level of IL-17in thalamic stroke without somnolence, and has statistically significance,.01. Conclusion:1. PSG is earlier than the sleep quality scales aboat detecting the change of sleep disorder. Therefore, PSG is an important electrophysiological index.2. Cognitive impirement is related with sleep structure feature and sleep-disordered breathing.3. Sleep disorder will take longer in thalamic stroke. Monitoring sleep structure may be an important index for forecasting the prognosis of disease.4. The level of hypoctetin in acute thalamic stroke was notedly reduced, reminding that sleep disorder after thalamic stroke is a reliable biochemical factor, but it need further discuss how thalamic stroke patients with somnolence effects hypocretin in serum. Compared with control group, the level of inflammatory factor was higher, it was provide the mechanism of inflammatory in stroke, and suggesting that IL-17may participated in the occurrence of sleep disorders and inflammatory pathological mechanism in acute thalamic stroke.