目的：研究维持性血液透析患者睡眠质量与微炎性反应状态等因素的相关性，寻求改善睡眠质量的关键点。方法：将入组的147例维持性血液透析患者作为研究对象，根据匹兹堡睡眠质量指数量表（ PSQI）将研究对象分为睡眠良好组（ PSQI评分≤5分）和睡眠不良组（ PSQI评分>5分），收集两组的一般资料及实验室资料为观察项目，通过统计学方法分析观察项目与睡眠质量的相关性。结果：147例维持性血液透析患者睡眠不良的发生率为58.5%。其中年龄、透析龄、BDI评分、SAG评分、hsCRP、血红蛋白、肌酐、血钙、血磷、iPTH比较，差异有统计学意义（P<0.05）。二元logistic回归方程分析提示hsCRP、透析龄、BDI评分、SAG评分、血磷、iPTH有统计学意义，且OR>1。结论：微炎性反应状态、透析龄、抑郁、营养不良、血磷、iPTH为睡眠不良的独立危险因素。改善微炎性反应状态、调节iPTH水平及钙磷代谢对睡眠质量至关重要。抑郁对睡眠影响显著，精神层面的治疗与躯体治疗有一样重要的临床意义。%Objective To Study on the correlation between Sleep Quality and Microinflammation status and the other factors in mainte-nance hemodialysis patients for seejing the jey point to improve the quality of sleep. Method The group of 147 maintenance hemodialysis pa-tients as the research object,according to the Pittsburgh Sleep Quality Index( PSQI),they were divided into sleep good group( PSQI score≤5)and poor sleep group(PSQI score > 5),the general information and laboratory data of two groups were collected and analysed by statisti-cal method to investigate the correlation between observed projects and sleepquality. Results The dyssomnia currence rate of 147 maintenance hemodialysis patients was 58. 5%. Signicant differences were shown in age,dialysis duration,BDI score,SAG score,hsCRP,hemoglobin,serum creatinine,serum calcium,serum phosphorus and iPTH,the diffevence was statistically significant( P <0. 05 ). Binary logistic regression showed that hsCRP,dialysis duration,BDI score,SAG score,serum phosphorus,iPTH were statistically significant,and the OR>1. Conclusion The microinflammatory status,dialysis duration,depression,poor nutrition,serum phosphorus,iPTH are independent risj factors of poor sleep. Improving the microinflammatory status,regulating the level of iPTH and the metabolism of calcium and phosphorus are very important for sleep quality. Depression has significant effect on sleep. Clinical significance of psychotherapy is as importantand as somatic treatment.
展开▼
