维持性血液透析患者睡眠质量影响因素分析

Sleep quality influence factors analysis of maintenance hemodialysis patients

目的分析维持性血液透析(MHD)患者睡眠质量的影响因素。方法选取2014年9月至2015年10月行维持性血液透析至少4个月的128例终末期肾病患者。根据患者的透析时间长短,分为≥24个月组和<24个月组;根据患者的年龄大小,分为≥55岁组和<55岁组。比较透析时间不同和年龄不同的患者匹兹堡睡眠质量指数(PSQI)评分的差异;根据PSQI评分分为睡眠质量良好组、睡眠质量较差组及睡眠质量极差组,并调查分析三组合并有高血压或糖尿病的患者比率,血清钙、磷值及血红蛋白量水平。结果参与研究的MHD患者,透析时间≥24个月组各项目PSQI评分均显著高于<24个月组,差异具有统计学意义(P<0.05)。≥55岁组各项目PSQI评分均显著高于<55岁组,差异具有统计学意义(P<0.05)。睡眠质量良好组、睡眠质量较差组及睡眠质量极差组的年龄、透析时间、血清钙、磷值,血红蛋白量及合并高血压病或糖尿病等指标的PSQI评分比较,差异有统计学意义(P<0.05)。患者年龄、透析时间、磷值及合并高血压病或糖尿病的患者比率越高,血清钙、血红蛋白量越低,睡眠质量越差。结论终末期肾病患者的年龄,透析时间,血清钙、磷值,血红蛋白量及是否合并高血压病或糖尿病,均可影响患者的睡眠质量,引起不同程度的睡眠障碍。

Objective To analyse the influence of sleep quality factors in maintenance hemodialysis（ MHD） patients. Methods From September 2014 to October 2015 in our hospital 128 cases of end-stage renal disease patients for maintenance hemodialysis at least four months were selected. Sleep quality was evaluated by the Pittsburgh sleep quality index（ PSQI）. According to patients＇ dialysis duration,they were divided into ≥24 months group and24 months group; According to patients＇ age,they divided into ≥55 years old group and55 years old group.The PSQI scores between different age groups and different dialysis time groups were compared; According to the PSQI score,they were divided into good sleep quality group,poor sleep quality group and very poor quality sleep group. The morbidity of hypertension and diabetes,serum calcium and phosphorus values and hemoglobin differences in different sleep quality groups were compared. Results PSQI scores in ≥24 months group were significantly higher than those in24 months group with statistically significant difference（ P〈0.05）. The PSQI scores in ≥55 years old group were significantly higher than those in55 years old group with statistically significant difference（ P〈0.05）. The age,dialysis duration,serum calcium,phosphorus value,amount of hemoglobin and whether combined with hypertension or diabetes in good sleep quality group,poor sleep quality group and very poor sleep quality group were statistically different（ P〈0.05）. Conclusion The age,dialysis time,values of serum calcium,phosphorus,hemoglobin content and whether merge hypertension or diabetes can affect the end-stage renal disease patient＇s quality of sleep and cause different degree of sleep disorders.