急性心肌梗死患者的睡眠质量调查

Investigation on the sleep quality in patients with acute myocardial infarction

目的:进行急性心肌梗死(acutemyocardialinfarction,AMI)患者睡眠紊乱调查,研究其规律性。方法:2000-05/2004-05深圳市坪地医院心内科住院的AMI患者91例,符合纳入标准的AMI患者73例(患者组),其中男47例,女26例。选择同期本院健康体检自愿者67例为对照组,男44例,女23例。患者组接受了睡眠质量调查和精神卫生症状自评量表(SCL-90)评估,并与对照组同期结果进行比较。结果:在睡眠质量比较中,患者组的入睡(1.18±0.29)、睡眠维持(0.44±0.08)、睡眠自评(0.79±0.10)、睡眠总时间(1.15±0.24)评分和睡眠质量总分(5.06±0.76)均明显高于对照组(0.91±0.24,0.29±0.05,0.52±0.08,0.79±0.18,3.19±0.59)(t=2.127～3.350,P<0.05～0.01)。AMI患者按睡眠质量总分分组后,高得分组(≥5.06分,39例)的平均住院时间、梗死面积、合并症数目均明显少于低得分组(<5.06分,34例),而前者中的日常生活活能力得分却明显高于后者(t=2.117～2.358,P均<0.05)。睡眠质量高得分组SCL-90中躯体化、强迫、抑郁、焦虑、恐怖、偏执和精神病性因子评分明显低于低得分组(t=2.129～2.057,P均<0.01～0.05)结论:AMI患者有明显的睡眠质量下降,睡眠质量下降常影响到患者的住院时间、梗死面积、合并症、日常生活活能力和精神心理表现。

AIM: To investigate the sleeping disorder in patients with acute myocardial infarction (AMI), so as to study the regularity. METHODS: A total of 73 AMI patients (AMI group, 47 males and 26 females), who were in accordance with the inclusion criteria, were selected from 91 AMI patients hospitalized in the Department of Cardiology, Pingdi Hospital of Shenzhen City from May 2000 to May 2004. Other 67 healthy physical examinees(44 males and 23 females) in this hospital at the same period were voluntarily taken as the controls. The patients were evaluated with the sleep quality inventory and symptom checklist-90 (SCL-90), and the results were compared with those in the control group. RESULTS: In comparison of the sleep quality, the scores of falling asleep (1.18±0.29), sleep keeping (0.44±0.08), sleep self-assessment (0.79±0.10), total sleep time(1.15±0.24) and total score of sleep quality (5.06±0.76) in the AMI group were all obviously higher than those in the control group (0.91±0.24, 0.29±0.05, 0.52±0.08, 0.79±0.18, 3.19±0.59) (t=2.127 to 3.350, P< 0.05 to 0.01). After dividing into groups with the total score of sleep quality, the mean duration of hospitalization, the infarcted area, the number of complications in patients with higher score (score ≥5.06, n=39) were obviously lower than those with lower score (score< 5.06, n=34), while the score of activities of daily life (ADL) was markedly higher in the former than in the latter (t =2.117 to 2.358,P< 0.05). Patients with higher score of sleep quality had obviously lower scores of somatization, compulsion, depression, anxiety, paranoid and psychosis than those with lower score of sleep quality (t=2.129 to 2.057, P< 0.01 to 0.05). CONCLUSION:AMI patients have lowered sleep quality, which has influence on the duration of hospitalization, infarcted area, complication,ADL and psychological manifestations.