睡眠质量及血清细胞因子水平对重症病人ICU获得性衰弱的影响  

Effects of sleep quality and serum cytokine levels on ICU-acquired weakness in ICU patients

作　　者：闫亚敏 杜瑞芳[1] 潘文彦[1] 王晓容 虞正红[1] 胡燕[1] YAN Yamin;DU Ruifang;PAN Wenyan;WANG Xiaorong;YU Zhenghong;HU Yan(Zhongshan Hospital Fudan University,Shanghai 200032 China)

机构地区：[1]复旦大学附属中山医院,上海200032

出　　处：《护理研究》2022年第11期1881-1886,共6页Chinese Nursing Research

基　　金：复旦大学附属中山医院青年基金项目,编号:2019ZSQN01;复旦大学复星护理科研基金项目,编号:FNF201945。

摘　　要：目的:探讨重症病人睡眠质量及血清细胞因子水平对ICU获得性衰弱(ICU-AW)的影响。方法:选择2020年1月1日—2020年12月31日在复旦大学附属中山医院外科ICU住院的病人278例。采用理查兹-坎贝尔睡眠量表、医学伦理委员会评分(MRCscore)调查病人的睡眠质量及ICU-AW的发生率。转入ICU次日06:00~07:00抽取静脉血进行血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)及降钙素原因子水平检测。结果:32例病人被诊断为ICU-AW,发生率为11.5%,持续时间为3.00(1.00,8.00)d。85例接受机械通气治疗的病人ICU-AW发生率为23.5%,高于非机械通气病人ICU-AW发生率(6.2%)。ICU病人睡眠质量对ICU-AW发生无明显影响。与低水平的Q1区间相比,IL-8和TNF-α表达水平Q4区间病人的ICU-AW发生率明显升高(P<0.05);趋势分析结果表明,随着IL-6、IL-8和TNF-α表达水平的升高,ICU-AW发生率有明显上升趋势(P<0.05)。结论:重症病人睡眠质量与ICU-AW发生无明显相关性,转入ICU 24 h内的血清IL-8和TNF-α水平升高会促进ICU-AW的发生,监测其变化对预防及早期干预ICU-AW有重要的临床意义。Objective:To investigate the effects of sleep quality and serum cytokine levels on ICU-acquired weakness(ICU-AW)in ICU patients. Methods:From January 1,2020 to December 31,2020,a total of 278 patients hospitalized in surgical ICU in Zhongshan Hospital,Fudan University were selected as the research subjects. Sleep quality and the incidence of ICU-AW of patients were investigated by using the Richards-Campbell Sleep Questionnaire and the Medical Research Council Score. Venous blood was extracted during 06:00 to 07:00within 24 hours after admission for cytokines detection,including interleukin(IL-2),IL-6,IL-8,IL-10,tumor necrosis factor α(TNF-α)and procalcitonin. Results:32 patients were diagnosed with ICU-AW,with an incidence of 11. 5% and a duration of 3. 00(1. 00,8. 00)days. The incidence of ICU-AW was 23. 5% in 85 patients received mechanical ventilation therapy,higher than the patients without mechanical ventilation therapy(6. 2%). The sleep quality had no significant effect on the occurrence of ICU-AW. Compared with Q1interval,the incidence of ICU-AW in patients in Q4 interval of IL-8 and TNF-α was significantly higher(P<0. 05). Trend analysis showed that with the increase of IL-6,IL-8 and TNF-α levels,the incidence of ICU-AW had a significant upward trend(P<0. 05).Conclusions:There was no significant correlation between sleep quality and the occurrence of ICU-AW in ICU patients. The elevated levels of serum IL-8 and TNF-α within 24 hours after admitted to ICU may promote the occurrence of ICU-AW,and monitoring the dynamic changes is of great clinical significance for the prevention and early intervention of ICU-AW.

关 键 词：重症病人 ICU获得性衰弱 睡眠质量 细胞因子 影响因素 

分 类 号：R473[医药卫生—护理学]