全国多中心慢性便秘患者情绪和睡眠状况的调查  

Multi-centered stratified clinical studies for psychological and sleeping status in patients with chronic constipation in China

作　　者：朱丽明[1] 方秀才[1] 刘诗[2] 张军[3] 李兆中[4] 胡品津[5] 高峻[4] 辛海威[1] 柯美云[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,100730 [2]华中科技大学同济医学院附属协和医院消化内科 [3]西安交通大学医学院附属第二医院消化内科 [4]第二军医大学长海医院消化内科 [5]中山大学附属第一医院消化内科

出　　处：《中华医学杂志》2012年第32期2243-2246,共4页National Medical Journal of China

基　　金：国家“十一五”科技支撑计划（2007BAl04801）

摘　　要：目的调查我国不同地区、不同级别医院慢性便秘患者的情绪和睡眠状况，分析情绪异常和睡眠障碍对慢性便秘患者的影响。方法2009年1月至2010年4月，全国5个中心25家医院纳入符合罗马Ⅲ诊断标准的慢性便秘患者，面对面问卷调查便秘症状、情绪和睡眠状况、就诊以及患者对便秘产生影响的自我评价等。组间差异分析采用t检验或x2检验。结果纳入慢性便秘患者909例，其中男258例、女651例；平均年龄（49±19）岁。41．5％（377例）的患者近3个月有情绪紧张，38．3％（348例）有情绪沮丧；经常和绝大多数时间出现情绪紧张者占11．3％（103例）、情绪沮丧者占9．4％（85例），归为情绪异常。43．8％（398例）的患者近3个月存在睡眠障碍。慢性便秘患者情绪异常发生率存在明显地区差别，北京地区情绪紧张和沮丧发生率最高（均P〈0．05）。二级医院中武汉和西安地区患者睡眠障碍发生率[66．1％（37／56）和65．0％（39／60）]高于北京和广州地区[39．7％（23／58）和29．0％（9／31），均P=0．001]；就诊于农村一级医院的患者睡眠障碍发生率高于城市一级医院（P=0．026）。分别有35．0％（318例）和28．4％（258例）患者认为便秘与情绪异常、睡眠障碍有关。重度便秘患者情绪异常和睡眠障碍发生率高于非重度便秘患者（P=0．000），情绪沮丧增加重度便秘患者的就诊次数（P=0．000）。结论慢性便秘患者伴发情绪异常和睡眠障碍存在地区差别，就诊于不同级别医院患者情绪异常和睡眠障碍发生率不同，便秘程度影响患者情绪、睡眠和就诊次数。Objective To survey the emotional and sleeping status of patients with chronic constipation （CC） and analyze the relationship between psychological status and constipated symptoms. Methods From January 2009 to April 2010, 5 centers and 25 stratified hospitals were selected as the representatives of different regions of China's Mainland. The CC questionnaires including constipated symptoms, emotional and sleeping status, previous treatments and self-reported impact of constipation on health status, etc. Questionnaires were completed by well-trained physicians or investigators during face-to- face interviews. CC was diagnosed in accordance with the Rome m criteria..Results A total of 909 valid questionnaires analyzed. There were 258 males and 651 females with a mean age of （49 - 19） years. 41.5% （377 cases）reported ＂tense feelings＂ and 38.3% （348 cases） ＂felt downcast＂ over the past 3 months. The patients feeling tense and （or） downcast ＂frequently＂ and ＂most of time＂ were around 11.3 % （ 103 cases）and 9.4% （85 cases）. And 43.8 % （398 cases ）patients reported sleeping disorders over the past 3 months. Regional differences existed in the comorbidities of psychological and sleeping disorders in CC patients, especially in those from tertiary hospitals. And it was the highest in Beijing area for tense feelings and downcast. The sleeping disorders were the most common in the patients from secondary hospitals, of which 66. 1% （ 37/56 ） and 65.0% （ 39/60 ） were from Wuhan and Xi＇ an respectively. They were higher than Beijing and Guangzhou （39.7% （23/58） ,29. 0% （9/31）, all P = 0. 001 ）. The patients from rural primary clinics suffered more sleeping disorders than those from urban primary cares （P = 0. 026）. About 35.0% （318 cases）and 28.4% （258 cases） patients reported their constipation was related with emotional and sleeping disorders. The comorbidities of psychological and sleeping disorders were more common in severe constipated patient

关 键 词：便秘 多中心研究 睡眠障碍 

分 类 号：R574.62[医药卫生—消化系统]