新发毒性弥漫性甲状腺肿患者日间功能、睡眠质量、心理稳定性变化分析

Analysis on the changes of daytime function, sleep quality and psychological stability of patients with emerging Graves disease

目的:探讨新发毒性弥漫性甲状腺肿(Graves)病患者日间功能、睡眠质量、心理稳定性的变化。方法:采用现况调研及病例对照研究方法,调查新发Graves病患者581例及健康对照800名。被调查者填写一般资料量表、愤怒郁怒体质调查表、匹兹堡睡眠质量指数量表(PSQI)、疲劳评定量表(FAI)。回收问卷,进行病例对照的多因素非条件Logistic回归分析。结果:多数新发Graves病患者日间功能差、睡眠质量下降、心理稳定性下降等发生的风险较大。心理稳定性下降发生风险存在性别差异,女性患者发生风险较大。睡眠质量下降表现在多维度,不同年龄、性别表现的维度不同。年龄大者表现为入睡所需时间延长,其发生风险度最大为健康对照组的1.235倍。不足30岁者仅在疲劳时心理稳定性下降。结论:Graves病为心身疾病,临床诊治时除典型症状外应注意患者有无日间功能障碍、睡眠质量下降、心理稳定性变差等,不同性别、年龄阶段问诊侧重点不同,针对不同症状给予相应的药物或心理治疗,以提高抗甲状腺药物治疗效果。

Objectives:To investigate the changes of the daytime function, sleep quality and psychological stability of patients with emerging Graves disease.Methods:Present situation research and case control research were conducted.All participants(581 patients and 800 normal controls) were asked to fill general data table, angry and yunu constitution questionnaire[1], pittsburgh sleep quality index(PSQI), and fatigue assessment instrument(FAI).Basic characteristics of all subjects were documented, and case-control multivariate logistic regression analysis was conducted.Results:The risk of poor daytime function, sleep quality and psychological stability of people with emerging Graves disease was relatively high.The risk of decrease of mental stability had differences in sex.There was a greater risk for female patients.The performance of sleep quality decreased in multiple dimensions in age and sex.Older people showed prolonged time to fall asleep, and the rate of maximum risk was 11.235 times than the control group.For young people(<30 years), the psychological stability did not decrease, except when they felt fatigued.Conclusion:Graves disease is one of psychosomatic diseases, endocrinologists should pay attention to whether patients have daytime dysfunction, decreased sleep quality, decreased mental stability and so on.Practitioners should stress on different aspect when doing consultation according to the gender and age.According to different symptoms, we should give the corresponding drug or psychological treatment, so as to improve the effect of anti-thyroid drugs(ATD).