单中心维持性血液透析患者睡眠质量调查及分析

Investigation and analysis of sleep quality in maintenance hemodialysis patients

目的调查维持性血液透析(MHD)患者睡眠质量,并分析影响其睡眠质量的因素,为进一步研究相应的预防措施及干预手段提供思路和依据。方法采用匹茨堡睡眠质量指数(PSQI)量表调查150名MHD患者的睡眠情况,并统计患者的年龄、性别、婚姻状况、透析时间、透析频率、平均超滤量、血红蛋白、甲状旁腺素(PTH)、白蛋白、尿素清除指数(Kt/V)。计算PSQI评分后进行分组,将PSQI评分≤5分者归为睡眠质量好组,PSQI评分>5分者归为睡眠质量差组,并进行各因素、各维度的比较。结果结果 150名MHD患者中82名(54.66%)患者PSQI总分大于5分。睡眠质量差组与睡眠质量好组在年龄、透析时间、血红蛋白、PTH、Kt/V等指标方面差异有显著性(P <0.05)。而在白蛋白、平均超滤量指标方面无显著差异(P> 0.05)。60岁以上患者与60岁以下患者PSQI量表中PSQI总分、睡眠效率、催眠药物方面比较差异有统计学意义(P <0.05),在睡眠质量、睡眠时间、入睡时间、睡眠障碍及日间功能障碍方面比较差异无统计学意义(P> 0.05);透析时间3年以上和透析时间3年以下的患者在PSQI量表中总分及各项评分比较差异均有统计学意义(P <0.05)。结论 MHD患者的睡眠质量普遍较差。高龄、透析时间长、血红蛋白降低、PTH升高、Kt/V降低更易导致睡眠质量差。

Objective To investigate the quality of sleep in maintenance hemodialysis patients and analyze the influencing factors of sleep disorders. Methods A total of 150 hemodialysis patients were investigated by Pittsburgh sleep quality index( PSQI) to assess the sleep quality.Global scores of these questionnaires were analyzed. A comparison between "good"( global PSQI≤5) and"bad"( global PSQI > 5) sleepers was done to analyze the reasons for sleep disturbances. Results 54.66% maintenance hemodialysis patients were"bad"sleepers( global PSQI >5). Age,dialysis vintage,hemoglobin,PTH and Kt/V showed significant differences between two groups( P < 0.05). There was no significant difference in albumin and UF between two groups( P> 0.05). Conclusions Sleep problem is common in maintenance hemodialysis patients. Older age,longer dialysis vintage,anemia and higher PTH,lower Kt/V are risk factors for poor sleep quality.