强直性脊柱炎患者疾病活动度与睡眠障碍的相关性研究  

Correlation between disease activity and sleep disturbances in patients with ankylosing spondylitis

作　　者：宋婧[1] 卢红娟[1] 赵娟[1] 彭华[1] 吴歆[1] 徐沪济[1] 

机构地区：[1]第二军医大学附属长征医院风湿免疫科,上海200003

出　　处：《诊断学理论与实践》2015年第4期343-347,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:评估强直性脊柱炎(ankylosing spondylitis,AS)患者的睡眠现状,探讨疾病活动度与睡眠障碍间的关系。方法:对67例AS患者进行问卷调查,统计其一般情况、疾病活动度、睡眠质量等指标,并抽取静脉血检测红细胞沉降率和C反应蛋白水平,分析各指标间的相关性。结果:1AS高疾病活动度组[Bath强直性脊柱炎疾病活动性指数(BASDAI)≥4]匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、失眠严重指数(Insomnia Severity Index,ISI)及阿森斯失眠量表(Athens Insomnia Scale,AIS)评分均显著高于低疾病活动度组(P均<0.01)。267例AS患者中,存在主观睡眠问题者占52.23%,入睡困难者占37.31%,实际睡眠时间减少者占31.34%,睡眠效率减低者占35.83%,因存在影响睡眠的事件而影响睡眠者占34.33%,因睡眠问题存在日间功能障碍者占46.27%,使用助眠药物者占2.99%。3PSQI、ISI、AIS与BASDAI间显著相关(P<0.01),与红细胞沉降率、C反应蛋白间亦具有相关性(P<0.05)。随着AS疾病活动度的增加,患者更易出现睡眠障碍。结论:AS患者易合并睡眠障碍,且随疾病活动度的增加程度加重;患者疼痛的严重程度、晨僵程度及BASDAI评分与其睡眠质量有关,且睡眠障碍会加重疼痛的程度,提示在AS的临床治疗中,不应忽视患者伴发的睡眠障碍。Objective： To evaluate sleep disturbances and their association with disease activity in ankylosing spondylitis（AS） patients. Methods： Sixty-seven patients with AS were enrolled and questionnaires were performed, including general condition of patients, disease activity, sleep quality and other indicators. C-reactive protein（CRP） and the erythrocyte sedimentation rate（ESR） were determined. Statistical analysis was performed by independent sample t test and Pearson/Spearman correlation test. Results： 1 The PSQI, ISI and AIS scores were significantly higher in patients with high disease activity（BASDAI ≥4） than those with low disease activity（P〈0.01）; 2 52.23% of patients had subjective sleep disturbances, 37.31% of patients had difficulty in falling asleep, 31.34% had reduction of sleep duration; 46.27% of patients had daytime dysfunction due to sleep problem. 3 PSQI, ISI and AIS were significantly correlated with BASDAI（P〈0.01） and were also correlated with ESR and CRP（P〈0.05）. Conclusions： The prevalence of sleep disturbances in AS patients is higher than it is generally thought to be. With the increasing of disease activity, sleep disorders would get more aggravating. It is suggested that pain, morning stiffness and BASDAI score have correlation with sleep disturbance, and evaluation and optimal management of pain and depression are needed to improve sleep quality in AS patients.

关 键 词：强直性脊柱炎 睡眠障碍 疾病活动度 

分 类 号：R593.23[医药卫生—内科学]