多囊卵巢综合征患者的睡眠质量及其影响因素分析  

The Influence Factors of Sleep Quality in Patients with Polycystic Ovarian Syndrome

作　　者：刘明铭[1] 余莎[2] 王满[3] 刘靖[4] 何新连 刘君英[1] 刘雪婷 陈泽龙[1] 阎德文[1] 张演善 蔡于茂[6] LIU Ming-ming;YU Sha;WANG Man;LIU Jing;HE Xin-lian;LIU Jun-ying;LIU Xue-ting;CHEN Ze-long;YAN De-wen;ZHANG Yan-shan;CAI Yu-mao(Department of Endocrinology,The Second People＇s Hospital of Shenzhen,Shenzhen 518035;Department of Gynecology,The Second People＇s Hospital of Shenzhen,Shenzhen 518035;Department of Coloproctology,The Second People＇s Hospital of Shenzhen,Shenzhen 518035;Department of Medical Examination,The Second People＇s Hospital o1,Shenzhen,Shenzhen 518035;Department of Psychological Test,Shenzhen Kangn-ing Hospital,Shenzhen 518020;Shenzhen Center for Chronic Disease Control and Prevention,Shenzhen 518020)

机构地区：[1]深圳市第二人民医院内分泌科,深圳518035 [2]深圳市第二人民医院妇科,深圳518035 [3]深圳市第二人民医院肛肠科,深圳518035 [4]深圳市第二人民医院体检科,深圳518035 [5]深圳市康宁医院心理测验室,深圳518020 [6]深圳市慢性病防治中心,深圳518020

出　　处：《中国中西医结合杂志》2018年第10期1185-1189,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：深圳市科技计划项目(No.JCYJ20140414170821332)

摘　　要：目的评价多囊卵巢综合征(PCOS)患者的睡眠质量,并分析其可能存在的影响因素。方法纳入PCOS患者47例为PCOS组,月经规律的健康女性29名作为对照组。采用匹茨堡睡眠质量指数(PSQI)量表(包括主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物的使用、日间功能障碍)评价两组睡眠质量。同时测定患者生化指标[包括游离睾酮(FT)、血卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、泌乳素(PRL)、孕酮(PROG)及空腹血糖(FBG)、胰岛素(INS)]水平,计算胰岛素抵抗指数(HOMAIR)。利用逐步回归分析方法探究影响睡眠质量的因素。结果与对照组比较,PCOS组中LH/FSH、PRL、PROG、FT、HOMA-IR水平均升高(P <0. 05,P <0. 01),呼吸不畅、打鼾症状、主观睡眠质量、入睡时间、睡眠效率、睡眠障碍、日间功能障碍评分及PSQI总分更高(P <0. 05,P <0. 01)。LH/FSH及FT水平升高和PSQI分数升高呈正相关(F=10. 97,4. 39,P=0. 0015,0. 0396)。BMI正常PCOS患者PSQI指数为(7. 310±3. 037),BMI异常患者PSQI指数为(6. 667±4. 000),二者比较差异无统计学意义(P> 0. 05)。结论 PCOS患者较月经规律的健康女性睡眠质量更差。LH/FSH比值偏高、FT偏高和睡眠质量降低有关。Objective To evaluate the sleep quality in patients with polycystic ovary syndrome（ PCOS）and analyze the possible influencing factors. Methods Forty-seven patients with PCOS were enrolled in the PCOS group,and 29 healthy women with regular menstruation were enrolled in the control group in this study. The sleep quality in all participants was evaluated by Pittsburgh Sleep Quality Index（ PSQI） Scale,which including subjective sleep quality,sleep latency,sleep time,sleep efficiency,sleep disturbance,usage of hypnotic drugs and daytime dysfunction. Biochemical indicators,including follicular stimulating hormone（ FSH）,luteinizing hormone（ LH）,free testosterone（ FT）,estradiol（ E2）,prolactin（ PRL）,progesterone（ PROG）,fasting blood glucose（ FBG）,fasting insulin（ INS） and insulin resistance index（ HOMA-IR） were also analyzed and compared between the two groups.Stepwise regression method was used to explore the influencing indicators affecting sleep quality. Results Compared with the control group,LH/FSH,PRL,PROG,FT,and HOMA-IR levels were increased in the PCOS group（ P〈0. 05,P〈0. 01）. The scores of poor breathing,and snoring symptoms,subjective sleep quality,sleep latency,sleep efficiency,sleep disturbance,daytime dysfunction score and PSQI total score were also increased（ P〈0. 05,P〈0. 01）. There was a positive correlation between elevated LH/FSH and FT levels and increased PSQI scores（ F= 10. 97,4. 39,P = 0. 0015,0. 0396）. The PSQI index of patients with normal BMI was 7. 310 ± 3. 037,and the PSQI index of patients with abnormal BMI was 6. 667 ± 4. 000. There was no significant difference between the two kinds of patients（ P〈0. 05）. Conclusions PCOS patients had lower quality of sleep comparing to the healthy women with regular menstruation. The higher LH/FSH ratio and higher FT level was associated with the lower sleep quality in PCOS patients.

关 键 词：睡眠障碍 多囊卵巢综合征 匹茨堡睡眠质量指数量表 

分 类 号：R711.75[医药卫生—妇产科学]