原发性慢性失眠患者失眠严重程度与抑郁和焦虑的相关性研究  

Study on the correlation between insomnia severity and depression and anxiety in patients with primary chronic insomnia

作　　者：高向阳 李霞[2] 徐三平[3] 贺明霞 张淑珍 辛杰 王倩[7] 梁丽华 李慧[9] 包春华[10] 李彦 刘娜 朱元芳[13] 王莉晴 曾强 GAO Xiangyang;LI Xia;XU Sanping;HE Mingxia;ZHANG Shuzhen;XIN jie;WANG Qian;LIANG Lihua;LI hui;BAO Chunhua;LI Yan;LIU Na;ZHU Yuanfang;WANG Liqing;ZENG Qiang(Health Mangement Institute,The Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China;Health Mangement Center of HanDan Central Hospital,Handan 056000,Hebei,China;Health Mangement Center of Wuhan Union Hospital,Wuhan 430022,Hubei,China;Health Mangement Center of Zhengzhou Yihe Hospital,Zhengzhou 450018,Henan,China;Health Mangement Center of The Second Hospital of Weinan,Weinan 714099,Shanxi,China;Health Mangement Center of Baoji High-tech Hospital,Baoji 721013,Shanxi,China;Health Mangement Center of The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shanxi,China;Health Mangement Center of Liaoning Electric Power Center Hospital,Shenyang 110403,Liaoning,China;Health Mangement Center of Hunan Provincial People’s Hospital,Changsha 410021,Hunan,China;Health Mangement Center of Rui’an People’s Hospital,Rui’an 325207,Zhejiang,China;Health Mangement Center of CHongqing Unviersity Three Gorges Hospital,Chongqing 404031,China;Health Mangement Center of Guangzhou cadre sanatorium,Guangzhou 510970,Guangdong,China;Health Mangement Center of Zigong Fourth People’s Hospital,Zigong 643099,Sichuan,China;Health Mangement Center of Guang’an People’s Hospital,Guang’an 638099,Sichuan,China.)

机构地区：[1]中国人民解放军总医院第二医学中心健康管理研究院,北京100853 [2]邯郸市中心医院健康管理中心,河北邯郸056000 [3]武汉协和医院健康管理中心,湖北武汉430022 [4]郑州颐和医院健康管理中心,河南郑州450018 [5]渭南市第二医院健康管理中心,陕西渭南714099 [6]宝鸡高新医院健康管理中心,陕西宝鸡721013 [7]西安交通大学第二附属医院健康管理中心,陕西西安710004 [8]辽宁电力中心医院健康管理中心,辽宁沈阳110403 [9]湖南省人民医院健康管理中心,湖南长沙410021 [10]瑞安市人民医院健康管理中心,浙江温州325207 [11]重庆大学附属三峡医院健康管理中心,重庆404031 [12]广州市干部疗养院,广东广州510970 [13]自贡市第四人民医院健康管理中心,四川自贡643099 [14]广安市人民医院健康管理中心,四川广安638099

出　　处：《健康体检与管理》2023年第3期264-269,共6页Journal of Health Examination and Management

摘　　要：目的:分析原发性慢性失眠患者中抑郁及焦虑对失眠严重程度的影响。方法:方法:本研究为横断面调查,在全国13个城市招募有失眠症状的18~65岁成年人,对其中诊断为原发性慢性失眠的患者,通过问卷获取年龄、性别等信息;以及抑郁自评量表(SDS)、焦虑自评量表(SAS)和匹兹堡睡眠质量指数问卷(PSQI)得到SDS得分、SAS得分、PSQI得分等指标;根据PSQI评分将患者的慢性失眠分成轻度失眠、中度失眠、重度失眠3个等级,通过有序多分类Logistic回归,分析焦虑和抑郁对原发性慢性失眠严重程度的影响。结果:结果:本研究在有失眠症状的4189例个体中,筛选出符合纳入排除标准的研究对象595例,其中,轻度失眠者237例(39.80%)、中度失眠者322例(54.10%)、重度失眠者36例(6.1%)。有序多分类Logistic回归分析发现,抑郁及焦虑程度对失眠严重程度具有统计学意义,而病程、年龄、性别、合并慢性病、婚姻状况、经济水平和职业状况均无统计学意义。原发性慢性失眠患者的SDS得分每增加1分,其“失眠严重程度增加”的OR值为原来的1.041倍[95%CI(1.017~1.064)];原发性慢性失眠患者的SAS得分每增加1分,其“失眠严重程度增加”的OR值为原来的1.051倍[95%CI(1.026~1.077)]。结论:结论:焦虑和抑郁是原发性慢性失眠患者失眠严重程度的独立影响因素;抑郁或焦虑越严重,失眠程度也越重。Objective:To analyze the effects of depression and anxiety on the severity of insomnia in patients with primary chronic insomnia.Methods:This study was a cross-sectional survey of 18 to 65 year old adults with insomnia symptoms recruited from 13 cities across the country.Among them,patients diagnosed with primary chronic insomnia were asked to obtain information such as age and gender through questionnaires;And indicators such as SDS scores,SAS scores,and PSQI scores obtained from the Self Rating Depression Scale(SDS),Self Rating Anxiety Scale SAS,and Pittsburgh Sleep Quality Index(PSQI);According to the PSQI score,the patients’chronic insomnia was divided into three grades:mild insomnia,moderate insomnia,and severe insomnia.The effect of anxiety and depression on the severity of primary chronic insomnia was analyzed through an ordered multiple classification logistic regression.Results:In this study,among 4189 individuals with insomnia symptoms,595 subjects who met the inclusion and exclusion criteria were selected,including 237 cases of mild insomnia(39.80%),322 cases of moderate insomnia(54.10%),and 36 cases of severe insomnia(6.1%).Ordered multiple classification logistic regression analysis found that the degree of depression and anxiety had a significant impact on the severity of insomnia,while the duration of disease,age,gender,concurrent chronic diseases,marital status,economic level,and occupational status had no significant impact.The OR value of“increased severity of insomnia”in patients with primary chronic insomnia is 1.041 times greater for 1 score increase in SDS scores[95%CI(1.017,1.064)];For patients with primary chronic insomnia,the OR value of“increased severity of insomnia”is 1.051 times greater for 1 score increase in SAS scores[95%CI(1.026,1.077)].Conclusion::Anxiety and depression are independent influencing factors for the severity of insomnia in patients with primary chronic insomnia;The more severe depression or anxiety,the greater the degree of insomnia.

关 键 词：慢性失眠 匹兹堡睡眠质量指数 抑郁自评量表 焦虑自评量表 抑郁 焦虑 

分 类 号：R749[医药卫生—神经病学与精神病学]