原发性干燥综合征患者睡眠质量情况及其对病情影响分析  

Quality of sleep in patients with primary Sjögren′s syndrome and its influence on clinical features

作　　者：韩晓蕾[1] 石磊[2] 任夏瑾 陈静[1] 武丽 田峰[1] Han Xiaolei;Shi Lei;Ren Xiajin;Chen Jing;Wu Li;Tian Feng(Department of Mental Health,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Rheumatology and Immunology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院精神卫生科,太原030001 [2]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中华风湿病学杂志》2022年第3期179-184,共6页Chinese Journal of Rheumatology

基　　金：山西省自然科学研究面上项目(20210302123281);山西医科大学第二医院博士基金(202001-4)。

摘　　要：目的旨在探讨pSS患者睡眠质量情况及其对疾病特征的影响。方法收集2019年1月至2021年4月于山西医科大学第二医院风湿免疫科住院的100例pSS患者人口统计学、临床和实验室资料。采用匹兹堡睡眠质量指数(PSQI)、疲劳严重程度评分(FSS)、欧洲五维健康问卷(EQ-5D)、贝克抑郁量表第2版(BDⅠ~Ⅱ)、视觉模拟评分量表(VAS)对患者症状和整体状况进行评估,分析pSS患者睡眠质量情况及其对病情的影响。应用χ^(2)检验、独立样本t检验、Mann-WhitneyU检验、Logistic回归分析处理数据。结果pSS患者睡眠障碍发生率为42.0%(42/100),在不伴抑郁症的pSS患者中睡眠障碍的发生率为28.8%(17/59)。睡眠障碍组患者EQ-5D[0.66(0.59,0.76)]、EULAR干燥综合征疾病活动指数(ESSDAI)评分[1.0(0.0,3.0)]分别低于睡眠良好者[0.76(0.71,1.20)]和[2.5(1.0,4.0)](Z=3.07,P=0.012;Z=3.18,P=0.011)。睡眠障碍组患者EULAR干燥综合征患者报告指数(ESSPRI)评分[6.2(4.8,7.9)]、整体眼干燥VAS[60.0(21.4,82.1)]、焦虑VAS[11.0(2.9,43.0)]、患者总体评估(PGA)VAS[46.0(18.0,65.0)]、FSS[4.34(3.01,5.61)]和BDⅠ~Ⅱ[15.1(7.3,22.4)]均高于睡眠良好组患者的[4.1(2.8,5.3)]、[40.0(7.0,70.3)]、[2.3(0.0,18.0)]、[11.0(0.0,52.0)]、[2.45(1.65,4.40)]和[7.4(4.3,12.8)],差异均有统计学意义(Z=2.03,P=0.043;Z=2.04,P=0.042;Z=2.19,P=0.031;Z=3.00,P=0.015;Z=3.43,P=0.001;Z=3.12,P=0.003)。睡眠障碍组患者淋巴细胞计数[(2.0±1.5)×10^(9)/L]、ESR[(46±20)mm/1 h],均高于睡眠良好组的[(1.4±1.3)×10^(9)/L、(38±17)mm/1 h](t=2.00,P=0.048;t=2.04,P=0.044)。PSQI评分与IgG(r=-0.20,P=0.012)、ESSDAI呈负相关(r=-0.26,P=0.004),与FSS(r=0.38,P=0.001)、BDⅠ~Ⅱ(r=0.47,P=0.014)、ESSPRI(r=0.46,P=0.001)、白细胞计数(r=0.28,P=0.013)或中性粒细胞绝对数(r=0.26,P=0.009)呈正相关。多因素分析结果提示白细胞减少[OR值(95%CI)=0.245(0.065,0.692),P=0.005]是发生睡眠障碍的危险因素。结论pSS伴睡眠障碍时,通过影响患�Objective To investigate the quality of sleep in primary Sjögren′s syndrome(pSS)patients and its impact on clinical features.Methods One hundred patients with pSS who were hospitalized in the Department of Rheumatology of the Second Hospital of Shanxi Medical University from January 2019 to April 2021 were included into this study.Pittsburgh sleep quality index(PSQI),fatigue severity score(FSS),Euro QOL five dimensions questionnaire(EQ-5D),beck depression inventory second edition(BDⅠ-Ⅱ)and visual analog scale(VAS)were used to assess patients'symptoms and overall condition.The data was statistically managed and compared byχ^(2)test,independent sample t test,Mann-Whitney U test,and Logistic regression.Results The prevalence of sleep disorders in pSS patients was 42.0%(42/100).The prevalence of sleep disturbance in pSS patients without depression was 28.8%(17/59).The EQ-5D[0.66(0.59,0.76)]and Eur-opean league against rheumatism Sjögren's syndrome disease activity index(ESSDAI)scores[1.0(0.0,3.0)]were lower in patients in the sleep-disordered group than in those[0.76(0.71,1.20)and 2.5(1.0,4.0)]who slept well[Z=3.07,P=0.012;Z=3.18,P=0.011],respectively.The European league against rheumatism Sjögren's syndrome patients report index(ESSPRI)scores[6.2(4.8,7.9)],VAS levels in overall dry eyes[60.0(21.4,82.1)],anxiety[11.0(2.9,43.0)],overall physician global assessment(PGA)[46.0(18.0,65.0)],fatigue severity scale(FSS)[4.34(3.01,5.61)],and BDⅠ-Ⅱ[15.1(7.3,22.4)]in patients with sleep disorder were higher than those[4.1(2.8,5.3),40.0(7.0,70.3),2.3(0.0,18.0),11.0(0.0,52.0),2.45(1.65,4.40),and 7.4(4.3,12.8)]of the normal sleep group[Z=2.03,P=0.043;Z=2.04,P=0.042;Z=2.19,P=0.031;Z=3.00,P=0.015;Z=3.43,P=0.001;Z=3.12,P=0.003].The sleep-disordered group had higher levels of lymphocyte count(2.0±1.5)×10^(9)/L and erythrocyte sedimentation rate(ESR)(46±20)mm/1 h respectively when compared with(1.4±1.3)×10^(9)/L and(38±17)mm/1 h in the good sleep group(t=2.00,P=0.048;t=2.04,P=0.044).PSQI scores were negatively corre

关 键 词：干燥综合征 睡眠障碍 疾病活动度 

分 类 号：R593.2[医药卫生—内科学]