高血压共病抑郁障碍患者睡眠质量及影响因素分析  

Sleep quality of hypertensive patients with comorbid depression and its influence factors

作　　者：杨永涛 崔利军 张云淑[1,2] 李建峰 孙秀丽[1] 严保平[1] 李林[1] 栗克清 YANG Yongtao;CUI Lijun;ZHANG Yunshu;LI Jianfeng;SUN Xiuli;YAN Baoping;LI Lin;LI Keqing(Jining Medical University,Jining 272000,China;不详)

机构地区：[1]济宁医学院,山东济宁272000 [2]河北省精神卫生中心,河北保定071000

出　　处：《实用医学杂志》2021年第16期2053-2057,2064,共6页The Journal of Practical Medicine

基　　金：河北省财政厅河北省卫生健康委政府资助临床医学优秀人才项目(编号:361014)。

摘　　要：目的研究高血压患者和高血压共病抑郁障碍患者的睡眠质量及其影响因素。方法以2016年河北省精神疾病流行病学调查中明确诊断为高血压病的3637例为研究对象。使用《美国精神障碍诊断与统计手册第4版轴Ⅰ障碍定式临床检查患者版》(SCID⁃I)进行精神障碍的诊断,匹兹堡睡眠质量指数(PSQI)量表评定睡眠质量,同时收集研究对象的一般资料。结果高血压共病抑郁障碍患者低睡眠质量发生率(74.44%)明显高于单纯高血压患者(18.29%,P<0.01),其中共病重性抑郁障碍(81.42%)和恶劣心境障碍(84.38%)的低睡眠质量发生率更为突出。高血压共病抑郁障碍患者PSQI总分及各因子分均高于单纯高血压病患者(P<0.05),共病患者上床时间早,入睡时间延长,实际睡眠时间缩短。logistic回归分析显示女性、文化程度低、家庭收入低、高血压病程长、精神疾病家族史阳性、合并抑郁障碍是影响高血压患者睡眠质量的危险因素。结论高血压合并抑郁障碍患者较单纯高血压患者低睡眠质量发生率更高,在共病重性抑郁及恶劣心境障碍时尤为突出,共病抑郁障碍是低睡眠质量的最主要因素。Objective To study the sleep quality of hypertensive patients with comorbid depression as well as its influence factors.Methods A total of 3637 people diagnosed with hypertension during the Hebei provincial mental disease epidemiological survey in 2016 were selected as the research subjects.The American Diagnostic and Statistical Manual of Mental Disorders(DSM⁃4)AXISⅠClinical Examination for Disorders(SCID⁃I)was used for the diagnosis of mental disorders,and the Pittsburgh Sleep Quality Index(PSQI)was used to evalu⁃ate sleep quality.Results The incidence of poor sleep quality of the hypertensive patients with depression was significantly higher than that in the patients with hypertension alone(74.44%vs.18.29%,P<0.01),and the inci⁃dence of poor sleep quality in the hypertensive patients with major depressive disorder(81.42%)and dysthymia(84.38%)was more prominent.The total score of PSQI and the scores of its dimensions in the hypertension patients with depression were higher than those in the patients with hypertension alone(P<0.05).The patients with both hypertension and depression went to bed earlier,slept longer,but their actual sleep time was shorter.Logistic regression analysis showed that female,low education level,low family income,long course of hyperten⁃sion,positive family history of mental illness,depression were the risk factors affecting the sleep quality of patients with hypertension.Conclusion The incidence of poor sleep quality among hypertensive patients with depression,especially among those patients with major depressive disorder and dysthymia,is much higher than among those with hypertension alone.Comorbid depression is the most common cause of poor sleep quality.

关 键 词：高血压 抑郁障碍 睡眠质量 SCID⁃I 匹兹堡睡眠质量指数 

分 类 号：R749[医药卫生—神经病学与精神病学]