综合医院失眠症患者的临床特征及用药情况调查

Clinical Characteristic of Insomniac Patients and Drug Utilization In General Hospital

目的 了解综合医院失眠症患者的临床特征及用药情况。方法 设立失眠门诊,利用调查表调查失眠及用药情况,匹兹堡睡眠质量指数测评患者睡眠质量。结果 123例失眠症患者,年龄24岁—81岁(57.7±14.2)。失眠原因:躯体和/或精神疾病引起者有63例(51.2％),躯体和/或精神疾病伴随其他原因者42例(34.1％)。失眠类型:4.9％为入睡困难,3.3％为早醒,7.3％为维持睡眠困难,混合型占84.5％。匹兹堡睡眠质量指数总均值15.5±3.10分,<60岁者的Ⅰ项(睡眠质量)和Ⅶ项(日间功能障碍)分值高于老人(>60岁)(2.5±0.54vs2.2±0.66;2.4±0.98vs2.0±1.03,p<0.05),女性Ⅳ项(睡眠效率)和总分高于男性(2.6±0.75vs2.1±1.05;16.1±2.99vs14.7±3.14,p<0.05)。87.0％的患者都有催眠药用药史,苯二氮(艹卓)类药物用药192人次,65.4％的患者催眠药用药期超过1年。>60岁的老年患者用药种数多于60岁以下者(3.4±2.3vs2.4±1.8,p<0.05)。50例患者有明显药物依赖。结论 躯体和/或精神疾病是引起病人失眠的主要原因,失眠类型主要为混合型,苯二氮(艹卓)类药物为患者常用药物,部分患者已产生药物依赖。

Objective To survey the clinical characteristic and drug utilization of insomniac patients in generalhospital. Method We set up an insomnia clinic,made questionnaire and rated sleep quality with Pittsburgh SleepQuality Index(PSQI). Result 123 insomniac patients aged 24 to 81 years(mean age: 57.7±14.2 y),insomnia was causedby physical or/and psychiatric disorder in 63(51.2%)patients,42(34.1%)patients' insomnia resulted from physical or/and psychiatric disorder accompanied by other factors.4.9% of patients complained of difficulty in sleeping initiation,7.3% difficulty in sleeping maintenance,3.3% of termination and 84.5% had all of the above complaints.The total scoreof PSQI was 15.5±3.10,score of item Ⅰ(subjective sleep quality), Ⅶ(daytime dysfunction)were higher in patients aged<60 y than elderly (2.5±0.54 vs 2.2±0.66; 2.4±0.98 vs 2.0±1.03, P<0.05).In women,score of item Ⅳ(habitual sleepefficiency)and total were higher than men(2.6±0.75 vs 2.1±1.05; 16.1±2.99 vs 14.7±3. 14,P<0.05). 87% of patientsused drugs to alleviate symptoms, and the frequency of benzodiazepines users was 192,65.4% of patients had used formore than one year, 50 patients developed drug dependence. Elderly used more drug numbers than those aged<60 y (3.4±2.3 vs 2.4±1.8,P<0.05).Conclusion The major cause of insomnia is psychiatric and/or medical disorder, manypatients complains of difficulty in sleeping initiation, sleeping maintenance or termination. Benzodiazepines is the mostcommon agent used by patients, some patients have developed dependence to it.