珠三角地区创伤患者睡眠障碍与PTSD关系  

Correlation between PTSD and sleep disorder: a research among patients from 8 hospitals in Pearl River Delta

作　　者：钱蕾[1,2] 梅鸾仙 龚艳艳[1] 周克雄[1] 史蕾[1] 

机构地区：[1]南方医科大学护理学院,广东广州510515 [2]南方医科大学基础学院人体解剖学教研室 [3]佛山市第五人民医院护理部

出　　处：《中国公共卫生》2014年第9期1190-1193,共4页Chinese Journal of Public Health

基　　金：2011年广东省大学生创新实验计划(1212111032);广东省高校优秀青年创新人才培育项目(WYM10090)

摘　　要：目的 了解珠江三角洲地区创伤住院患者创伤后应激障碍（PTSD）与睡眠障碍的发生情况及二者关系,并分析创伤后应激障碍患者睡眠障碍的影响因素。方法 采用目的抽样法抽取珠江三角洲地区708名创伤患者,使用PTSD平民版筛查问卷（PCL-C）、匹兹堡睡眠质量指数量表（PSQI）及自编影响因素调查表进行问卷调查。结果 珠江三角洲地区708名创伤患者PTSD发生率为27.5%,其中,轻或中度症状者占68.2%（133/195）,重度症状者占31.8%（62/195）;睡眠障碍的总发生率为37.9%,其中,无症状、轻度或中度、重度PTSD症状患者睡眠障碍发生率分别为27.9%（143/513）、57.9%（77/133）、77.4%（48/62）;无PTSD症状的513人中,PSQI均分为（6.79±3.78）分,睡眠障碍143人;轻度或中度PTSD症状的133人中,PSQI均分为（6.62±3.69）分,睡眠障碍77人;重度PTSD症状的62人中,PSQI均分为（7.26±3.72）分,睡眠障碍48人;PTSD自评量表PCL-C得分与PSQI得分呈正相关（r=0.480,P〈0.05）;不同程度的PTSD患者的睡眠总体情况及7个睡眠因子差异均有统计学意义（P〈0.001）;多因素分析表明,PTSD患者睡眠障碍的主要影响因素为距事故发生时间（OR=1.303,95%CI=1.129~1.503）、脊柱受伤（OR=1.991,95%CI=1.219~3.251）和生活自理程度（OR=1.684,95%CI=1.286~2.206）。结论PTSD患者的睡眠障碍随PTSD加剧而加重,不同程度的PTSD患者的睡眠障碍表现不同,主要受距事故发生时间,脊柱受伤与否及生活自理程度的影响。Objective To explore the correlation between post-traumatic stress disorder（PTSD） and sleep disorder among 708 patients from 8 hospitals in Pear1 River Delta, and to analyze influence factors of sleep quality among PTSD patients. Methods With target sampling,708 patients were chosen from 8 grade two hospitals in Pearl River Delta for a self-administrated anonymous questionnaire survey with PTSD Checklist-Civilian Version（PCL-C） and Pittsburgh Sleep Quality Index （PSQI） under the help of investigators. Results Among the patients, the overall prevalence of PTSD symptoms was 27. 5% ,with the proportion of 31.8% （62/195） for severe symptoms and 68.2% （133/195） for mild to moderate symptoms. The prevalences of sleeping problem were 37.9% for all the patients,27.9% （ 143/513 ） for the pa- tients without PTSD symptoms, and 57.9% （77/133） and 77.4% （48/62）for the patients with mild or moderate and se- vere PTSD symptoms, respectively. The average PSQI score was 6.79 ± 3.78 among the 513 patients without PTSD symptoms,with 143 patients having sleeping disorder; whereas,the score was 6. 62± 3.69 and 7.26 ± 3.72 among 133 patients with mild or moderate PTSD symptoms（77 having sleeping disorder） and 62 patients with severe PTSD symptoms（48 having sleeping disorder）. There was a positive correlation between PCL-C and PSQI （r = 0. 480, P 〈 0. 05 ）. There were significant differences in the general sleeping status and the 7 sleeping-related factors among the patients with different severity of PTSD symptoms. Multi-factor analyses showed that the main influence factors of sleep disorder for PTSD patients were the duration from the time of the accident（ odds ratiol OR] = 1. 303,95% confidence interval[95% CI] = 1.129 - 1. 503 ; P = 1. 303 ）, spinal injury （ OR = 1.991,95 % CI = 1.219 - 3.251 ; P = 0. 006 ） and ability of self- care （ OR = 1. 684,95 % CI = 1. 286 - 2. 206 ; P = 0. 000）. Conclusion PTSD and sleep disorder have a positive correlation. Patients with differe

关 键 词：创伤后应激障碍(PTSD) 睡眠障碍 影响因素 相关性 

分 类 号：R749.5[医药卫生—神经病学与精神病学]