“5·12”两年后地震亲历者睡眠障碍与刨伤后应激障碍的关联性探讨

Study on the relationship between dyssomnia and PTSD of earthquake survivors two years following ＂5.12＂ earthquake

目的了解“5．12”地震2年后江油、北川安置点地震亲历者的睡眠质量、心理应激水平及两者关系，为刨伤后应激障碍的进一步预测与治疗提供依据。方法以匹茨堡睡眠质量指数量表（PSQI）、创伤后应激障碍筛查量表平民版（PCL-C）为调查工具，采用系统抽样方法，评估地震亲历者的睡眠质量和心理应激水平及二者的关联性。结果PSQI测评结果显示地震2年后560例安置点亲历者中有33．8％发生睡眠障碍，7．5％发生创伤后应激障碍（PTSD）；睡眠良好组中，PTSD阴性358例占96．5％，PTSD阳性13例占3．5％；睡眠障碍组中，PTSD阴性160例占84．7％，PTSD阳性29例占15．3％。PTSD阴性组中，睡眠良好358例占69．1％，睡眠障碍160例占30．9％；PTSD阳性组中，睡眠良好13例占31．O％，睡眠障碍29例占69．0％。PSQI总分与PCL-C总分呈显著正相关；睡眠障碍影响因素的Logistic分析显示：受灾程度重、年龄大、心理应激状况差是发生睡眠障碍的相关因素。结论地震2年后板房灾民的睡眠质量、心理应激水平不容乐观。PTSD可引起睡眠障碍，同时睡眠障碍又会增加患PTSD的风险。

Objective To investigate the incidence of dyssomnia, posttraumatic stress disorder （PTSD） and their relationship in earthquake survivors in Jiangyou and Beichuan area, and supply evi- dence for prediction and treatment of PTSD. Methods Dyssomnia was accessed by Pittsburgh Sleep Quality Index （PSQI）, posttraumatic symptoms were measured using the PTSD Checklist-Civilian Ver- sion （PCL-C）. Results The prevalence of dyssomnia was 33.8%, the PTSD was 7.5%. In good sleep group, the number of people who didn＇t suffer from P1SD was 358 （96.5%）, the number of people who suf- fered from lYI＇SD was 13 （3.5%）; In dyssomnia group, the number of people who didn＇t suffer from PTSD was 160（84.7%）, the number of people who suffer from PTSD was 29（15.3%）. In PTSD negative group, the number of people who had good sleep was 358 （69.1%）; the number of people who had dyssomnia was 160 （30.9%）. In PTSD positive group, the number of people who had good sleep was 13（31.0%）, the number of people who had dyssomnia was 29（69.0%）.The correlation analysis showed that total scores of PCL-C were positively related with total score of PSQI. The logistic regression showed that the very hard-hit area, serious posttraumatic symptoms, were the dangerous factors of dyssomnia. Conclusions The dyssomnia and PTSD are still common among victims two years after ＂5.12＂ earthquake. PTSD can cause sleeping problem, meanwhile sleep problem could increase the risk of PTSD.