维持性血液透析患者失眠情况及其影响因素分析  

Insomnia and its related factors in maintenance hemodialysis patients

作　　者：张莹[1] 刘俊[1] 李兰英[1] 陶慧琴[1] 陈剑敏[1] 

机构地区：[1]南方医科大学南方医院肾内科,广州510515

出　　处：《中国血液净化》2007年第12期645-648,共4页Chinese Journal of Blood Purification

摘　　要：目的通过对广州南方医院血液透析中心患者失眠状况及相关因素进行调查,以探讨规律血液透析的失眠患病率及其影响因素。方法以67例透析龄>3月的患者为研究对象,分别采用阿森斯失眠量表(AIS)、Epworth嗜睡量表(ESS)、不宁腿诊断标准量表、匹兹堡睡眠质量指数(PSQI)进行评估。同时,记录患者的一般状况(性别、高血压、糖尿病、肾移植术后排斥、吸烟、喝茶、不宁腿综合征、嗜睡),透析参数(年龄、透析龄、干体重、体重指数、每周透析时间)和生化指标(血肌酐、尿素氮、Kt/V、血红蛋白、血细胞比积、铁蛋白、转铁蛋白饱和度、钾、校正总钙、磷、全段甲状旁腺激素、白蛋白、C-反应蛋白)。以AIS评分≥6分定为失眠,对失眠与非失眠2组进行统计学分析。结果①失眠患者占总人数的38.81%;②失眠组患者在PSQI的7项评分均显著高于非失眠组(P<0.05);③2组比较中,除不宁腿综合征、年龄、铁蛋白差异有显著性(P<0.05)外,其余指标的差异均无显著性;④二分类Logistic回归分析示不宁腿综合征和年龄是对失眠有显著影响的变量,其优势比分别为24.451、1.078。结论我中心维持性血液透析患者的失眠率为38.81%,所有失眠患者同时合并睡眠障碍,特别表现在主观睡眠质量、睡眠时间、习惯睡眠效应和日间功能方面。不宁腿综合征和年龄是失眠的危险因素,铁的缺乏和(或)未被清除的部分中分子物质可能会影响睡眠。Objective To evaluate the prevalence of insomnia and the factors related to insomnia in hemodialysis patients treated in this hemodialysis center. Methods Sixty-seven patients on maintenance hemodialysis were recruited in this study. Insomnia, excessive daytime sleepiness （EDS）, restless leg syndrome （RLS） and sleep quality were evaluated by the Athens Insomnia Scale （AIS）, Epworth Sleepiness Scale （ESS）, the criteria of the International Restless Legs Syndrome Study Group （IRLSSG） and Pittsburgh Sleep Quality Index （PSQI）. General state （gender, hypertension, diabetes, rejection after renal transplantation, smoking, drinking tea, RLS, EDS）, dialysis data （age, duration of hemodialysis, dry weight, body mass index and the time of hemodialysis per week）, and biochemical parameters （serum creatinine, blood urea nitrogen, Kt/V, hemoglobin, hematocrit, ferritin, transferring saturation, potassium, calcium, phosphorus, intact parathyroid hormone, albumin and C-reactive protein） were collected at the same time. We divided the patients into two groups： with insomnia （AIS score 〉 6） and without insomnia （AIS score 〈 6）. Statistical analyses were made between the two groups. Results ① The insomnia preva- lence was 38.81% obtained from questionnaire. ②The seven scores included in the PSQI were higher in the insomnia group than in the group without insomnia （P〈0.05）. ③ There were significant differences in age, serum ferritin and incidence of RLS （P 〈 0.05） between the two groups. ④ Binary Logistic regression analysis showed that RLS and age significantly influenced insomnia （P 〈 0.05）. The odds ratios were 24.451 and 1.078, respectively. Conclusion The prevalence of insomnia in maintenance hemodialysis patients in this hemodialysis center was 38.81%. Patients with insomnia also suffered from poor sleep quality, manifested by disorders in subjective sleep quality, sleep duration, habitual sleep and daytime efficiency. RLS and older age were the risk

关 键 词：失眠 血液透析 不宁腿综合征 年龄 

分 类 号：R692.5[医药卫生—泌尿科学]