焦虑与睡眠质量对初诊肺结核患者生命质量的交互作用  

Interaction of Anxiety and Poor Sleep Quality on Quality of Life of Newly Diagnosed Patients with Pulmonary Tuberculosis

作　　者：房桂华 石春雷[2] 马春燕 桑兴旺 沈玲玲[2] 韩勤 刘海英 娄培安[2] 

机构地区：[1]新疆伊犁哈萨克自治州奎屯医院,新疆奎屯8332002 [2]徐州市疾病预防控制中心,江苏徐州2210003 [3]奎屯市疾病预防控制中心,新疆奎屯833200

出　　处：《中国初级卫生保健》2016年第11期41-45,共5页Chinese Primary Health Care

基　　金：2015年奎屯市科技计划项目(201524)

摘　　要：目的 探讨焦虑与睡眠质量对肺结核患者生命质量的影响及在影响中的交互作用。方法 对奎屯地区2012年1月—2013年1月确诊管理的肺结核病（TB）患者,采用自行设定基本情况调查表和SF-36生命质量测量表、焦虑及抑郁自评量表、匹兹堡睡眠质量指数量表进行面对面调查;计量资料采用t检验,计数资料采用χ~2检验;多元线性回归分析肺结核病生命质量影响因素。结果 354例肺结核患者男性207例（58.47%）,女性147例（41.53%）,平均（45.21±18.71）岁,纳入该项研究。以睡眠质量好且无焦虑的患者为参照组,睡眠质量好但伴有焦虑且能够降低患者的生命质量﹝OR=3.96,95%CI（2.05~7.90）﹞;睡眠质量差但无焦虑同样也降低患者的生命质量﹝OR=2.54,95%CI（1.19~5.67）﹞;当睡眠质量差和焦虑同时存在时,患者生命质量严重下降﹝OR=14.98,95%CI（7.97~29.01）﹞。焦虑和睡眠质量差对肺结核患者生命质量的相加交互作用指数（S）为2.943﹝95%CI（1.304~6.642）﹞,相对超额危险度（RERI）为9.603﹝95%CI（1.287~17.919）,归因危险比（AP）为0.631﹝95%CI（0.367~0.894）﹞,交互作用指数（S）为3.077﹝95%CI（1.321~7.167）﹞。结论 焦虑和睡眠质量差对肺结核病患者生存质量具有交互作用,两因素同时存在时,对生存质量的危害大于单因素的作用。OBJECTIVE To explore the combined effects of anxiety and poor sleep quality on decreased quality of life in patients with newly diagnosed pulmonary tuberculosis. METHODS The patients with pulmonary tuberculosis who were newly diagnosed and adminis- tered during January 2012 to January 2013 in Kuitun City of Xinjiang autonomous region and Gulou District of Xuzhou in Jiangsu province were enrolled, self-designed questionnaire and SF-36 quality of life（QOL） measurement scale, anxiety and depression self-rating scales, the Pittsburgh sleep quality index scale were conducted by face to face interview; SPSS16. 0 Software was used, Measurement data using T tests testing, and count data using X2 test; use multiple liner regression to analyze influencing factors of QOL, and use stratify analysis to calculate relevant indicators interaction. RESULTS 354 patients whose average aged at 45.21±18.71 were investigated, of them, 207（58.47%） were male, 147（41.53%） were female; compared with patients with good sleep quality and without anxiety, patients with good sleep quality and anxiety possessed lower QOL [ OR=3.96 , 95%CI （2.05 ±7.90 ）3 , patients with poor sleep quality but either without anxiety possessed lower QOL [ OR=2.54,95%CI（1.19 ±5.67 ）3 ; by comparison, QOL of patients with poor sleep and anxiety had seriously deteriorated [ OR=14.98, 95%CI （7.97- 29.01 ）3. Calculated by crossover analysis, synergy index S（S）, attributable proportion of interaction（AP） and relative excess risk of interaetion（RERI） appeared to be 2.943 [ 95% CI（1.304- 6.642）3 , 0.631 [95%CI（0.367- 0.894）3 , 9.603 [95%CI（1.287 ±17.919） 3 respectively. CONCLUSION The interaction effect of sleep quality and anxiety had significant influence on QOL. These two factors existed at the same time produced more severe impairment than single-factor effect on QOL.

关 键 词：结核肺 焦虑 睡眠质量 生命质量 交互作用 

分 类 号：R521[医药卫生—内科学]