老年男性2型糖尿病患者睡眠质量相关因素分析  

Investigation of the correlative factors for sleep quality among elderly male patients with type 2 diabetes

作　　者：麻红艳 刘晓洁 葛余浩 尹长森 常虹 杨娟 Ma Hongyan;Liu Xiaojie;Ge Yuhao;Yin Changsen;Chang Hong;Yang Juan(Department of Geriatrics,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)老年医学科,合肥230001

出　　处：《中国临床保健杂志》2018年第5期609-612,共4页Chinese Journal of Clinical Healthcare

基　　金：安徽省年度重点科研项目(11070403035)

摘　　要：目的探讨与老年男性2型糖尿病睡眠障碍发生的相关因素,为老年男性2型糖尿病患者的综合管理提供指导。方法选取162例老年男性2型糖尿病患者为病例组,同时选取78例非2型糖尿病老年男性为对照组。通过匹兹堡睡眠指数(PSQI)量表对所有研究对象睡眠质量进行调查。测量血压、身高、体质量,计算体质指数(BMI);测定患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血肌酐(Cr)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C);尿清蛋白/肌酐比值(UACR),记录患者病程、周围神经病变和降糖药物使用情况等。结果病例组PSQI总分高于对照组,差异有统计学意义(t=11. 35,P <0. 001),其睡眠障碍发生率为63%;病例组在主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物的应用和日间功能障碍7个维度得分值均高于对照组(均P <0. 05)。在老年男性2型糖尿病患者中,与睡眠正常组相比,睡眠障碍组病程长、FBG及Hb A1c水平高,且糖尿病肾病、糖尿病周围神经病变发病率高、胰岛素使用率高(均P <0. 05)。logistic回归分析显示Hb A1c、UACR以及使用胰岛素与睡眠障碍发生相关(均P <0. 05)。结论在老年男性中,患有2型糖尿病的患者睡眠质量相对较差,且睡眠障碍患病率高。血糖控制不佳、合并糖尿病肾病以及使用胰岛素与老年男性2型糖尿病患者睡眠障碍相关。Objective To explore the correlative factors of sleep disorder among elderly male patients with type 2 diabetes in order to provide some guidances for integrated management of elderly male patients with type 2 diabetes. Methods 162 elderly male patients with type 2 diabetes were selected as the research subjects, and 78 elderly male pa- tients without type 2 diabetes were selected as the control group. The sleep quality- of research objects was evaluated u- sing Pittsburgh sleep index （PSQI） scale. Blood pressure, height,weight and body mass index（BMI） were measured, Fasting blood glucose （ FPG）, glycosylated hemoglobin A~ c （ HbA~ c）, serum creatinine （ Cr）, total cholesterol （ TC ）, tri- glyceride（TG） ,low density lipoprotein （LDL-C） and urinary albumi~/creatinine ratio（UACR） were detected, and dia- betic course, diabetic peripheral neuropathy and diabetes specific therapy were recorded. Results The case group showed higher PSQI total score than the control group（P 〈0.05） ,and the incidence rate of sleep disorder was 63% ; The scores of subjective sleep quality-, time to fall asleep, sleep time, sleep efficiency, sleep disorders, hypnotic drugs ap- plication and daytinle dysfunction in the case group were higher than those in the control group （ all P 〈 0.05）. In the case group, compared with the normal sleep group, the abnormal sleep group had longer course, a higher level of FBG and HbA1 c, higher incidences of diabetic nephropathy and diabetic peripheral neuropathy, and higher insulin utilization rate （ all P 〈 0.05 ）. Logistic analysis showed that HbA1 c, UACR and insulin utilization were correlated with diabetic sleep quality-. Conclusions In elderly men, patients with type 2 diabetes have less sleep quality- than those without type 2 diabetes,and have a high incidence of sleep disorders. Poor blood sugar control,diabetic nephropathy,and insulin use are associated with sleep disorders in elderly male patients with type 2 diabetes.

关 键 词：糖尿病 2型 入睡和睡眠障碍 危险因素 老年人/男人 

分 类 号：R587.1[医药卫生—内分泌]