肝性脑病患者睡眠障碍影响因素分析  

Influencing factors of sleep disorders in patients with hepatic encephalopathy

作　　者：王翠艳[1] 王道存[1] 董贾中[1] Wang Cuiyan;Wang Daocun;Dong Jiazhong(Puyang People's Hospital,Puyang 457000,Henan,China)

机构地区：[1]濮阳市人民医院,河南濮阳457000

出　　处：《临床心身疾病杂志》2025年第2期126-130,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的分析肝性脑病(HE)患者睡眠障碍的影响因素。方法统计124例HE患者的临床资料,并采用匹兹堡睡眠质量指数(PSQI)、医院焦虑抑郁量表(HADS)、领悟社会支持量表(PSSS)评定患者睡眠质量、焦虑、抑郁及社会支持状况,将其根据PSQI评分分为睡眠障碍组和无睡眠障碍组。采用单因素分析和多元Logistic回归分析探讨HE患者睡眠障碍的危险因素;建立风险预测模型,并评估模型拟合度和预测效能。结果124例HE患者睡眠障碍发生率为58.06%。两组患者年龄、文化程度、婚姻状况、月收入、PSSS评分、HADS焦虑评分、HADS抑郁评分、使用免疫抑制剂、疾病分类比较,差异均有统计学意义(P<0.05或0.01)。Logistic回归分析显示,年龄18~60岁、大专及以上文化程度、月收入<3000元、PSSS评分≤50分、HADS焦虑评分>8分、HADS抑郁评分>8分、使用免疫抑制剂、显性HE均是HE患者睡眠障碍的独立危险因素(P<0.05或0.01)。HE患者睡眠障碍的风险预测模型为:P=1/[1+e(-9.508+1.354×年龄+2.744×文化程度+0.978×月收入+1.538×PSSS评分+1.806×HADS焦虑评分+2.105×HADS抑郁评分+1.728×使用免疫抑制剂+1.937×疾病种类)];Hosmer-Lemeshow检验示,χ^(2)=13.224,P=0.104。ROC曲线显示,风险预测模型预测HE患者睡眠障碍的曲线下面积为0.931(P<0.05)。结论HE患者睡眠障碍发生率较高,其危险因素较多,临床可综合考虑这些因素,制定有效防控措施,提高患者的睡眠质量。Objective To analyze the influencing factors of sleep disorders in patients with hepatic encephalopathy(HE).Methods The clinical data of 124 HE patients were counted,the Pittsburgh Sleep Quality Index(PSQI),Hospital Anxiety and Depression Scale(HADS)and Perceived Social Support Scale(PSSS)were used to assess their sleep quality,anxiety,depression and social support status,and they divided into sleep disorders(SD)and non-SD group according to PSQI scores.Single factor analysis and multiple Logistic regression analysis were used to explore the risk factors for sleep disorders in HE patients.Risk prediction model was constructed and its goodness of fit and predictive efficacy were evaluated.Results The incidence of sleep disorders in the 124 HE patients was 58.06%.Intergroup differences in age,education level,marital status,monthly income,PSSS,HADS-anxiety and HADS-depression scores,immunosuppressant usage and disease types were statistically significant(P<0.05 or 0.01).Logistic regression analysis showed that 18~60 years old,education level of junior college or above,monthly income<3000 yuan,PSSS score≤50,HADS-anxiety score>8,HADS-depression score>8,immunosuppressant usage and dominant HE were all independent risk factors for sleep disorders in HE patients(P<0.05 or 0.01).The prediction model for risk of sleep disorders was:P=1/(1+e[-9.508+1.354×age+2.744×education level+0.978×monthly income+1.538×PSSS score+1.806×HADS-anxiety score+2.105×HADS-depression score+1.728×immunosuppressant use+1.937×disease type]),Hosmer-Lemeshow test show:χ^(2)=13.224,P=0.104.Receiver operating characteristic curve showed that the area under the curve of the risk prediction model predicting sleep disorders in HE patients was 0.931(P<0.05).Conclusion The incidence of sleep disorders in HE patients is higher,risk factors are more,and clinically effective prevention and control measures should be formulated aiming at the factors to improve patients'sleep quality.

关 键 词：肝性脑病 睡眠障碍 影响因素 

分 类 号：R747.9[医药卫生—神经病学与精神病学]