系统性红斑狼疮患者睡眠障碍及相关因素研究

Associated factors on sleep disorders in systemic lupus erythematosus patients

目的探讨SLE患者睡眠障碍的发生率及影响因素。方法共纳入100例SLE患者，采用匹兹堡睡眠质量量表（PSQI）、抑郁症筛查量表（PHQ）-9、广泛性焦虑量表（GAD）-7、健康调查量表（SF-36）、疲劳视觉模拟评分法（VAS）进行调查，收集人口学及临床资料，以SLEDAI评估疾病活动度，SLE损伤指数（SDI）评估疾病损伤程度。采用Mann-Whitney U秩和检验、t检验，Logistic回归行统计学处理。结果SLE患者睡眠障碍的发生率为42%（42/100）。SLE睡眠障碍组中男性比例、已婚比例、年龄、SDI、PHQ-9、GAD-7、疲劳VAS评分均高于睡眠正常组，而SF-36的8个维度、健康变化及SF-36总分低于睡眠正常组（P〈0.05）。年龄、SLEDAI、SDI、PHQ-9、GAD-7、疲劳VAS评分与PSQI总分呈正相关（r值分别为0.251、0.230、0.311、0.529、0.455、0.541，P〈0.05），补体C3、SF-36的8个维度、健康变化及总分与PSQI总分呈负相关（r值分别为-0.204、-0.342、-0.490、-0.464、-0.497、-0.590、-0.428、-0.478、-0.398、-0.412、-0.659，P〈0.05）。Logistic回归分析显示，性别（OR=22.22）、焦虑（OR=2.895）、躯体疼痛（OR=0.964）、精力（OR=0.974）为睡眠障碍的独立危险因素（R2=0.494，P〈0.01）。结论SLE患者睡眠障碍的发生率较高，与性别、年龄、疾病活动度、疾病损伤程度、焦虑、抑郁、生活质量等密切相关。

ObjectiveTo investigate the prevalence of sleep disorders and the relevant determinants in a cohort of systemic lupus erythematosus （SLE） patients.MethodsOne hundred patients with SLE were included in the study. Sleep quality was assessed using the Pittsburgh sleep quality index （PSQI）. Depression, anxiety, quality of life, and fatigue were evaluated by patient health questionnaire （PHQ）-9, generalized anxiety disorder （GAD）-7, short form 36 health survey （SF-36）, and visual analogue scale （VAS） respectively. The demographic and clinical data were also recorded. SLE disease activity and damage severity were assessed by systemic lupus erythematosus disease activity index （SLEDAI） and systemic lupus erythematosus damage index （SDI） respectively. Mann-Whitnry U test, t test, Logistic regression were used for statistically analysis.ResultsThe prevalence of sleep disorders in SLE patients was 42%. Compared with patients without sleep disorders, the ratio of males and married patients, age, the score of SDI, PHQ-9, GAD-7, and fatigue were higher in SLE patients with sleep disorders, while the score of SF-36 was lower （r〈0.05）. Age, SLEDAI, SDI, PHQ-9, GAD-7, and fatigue correlated positively with sleep disorders （The values of r were 0.215, 0.230, 0.311, 0.529, 0.455, 0.541, P〈0.05）. C3 and the score of SF-36 correlated negatively with sleep disorders （The values of r were-0.204,-0.342,-0.490,-0.464,-0.497,-0.590,-0.428,-0.478,-0.398,-0.412,-0.659 respectively, P〈0.05）. In multi-ple logistic regression analyses, gender （OR=22.22）, anxiety （OR=2.895）, body pain （OR=0.964）, and energy （OR=0.947） were the independent determinants of sleep disorders （R2=0.494, P〈0.01）.ConclusionPoor sleep quality is common in SLE patients. Gender, age, disease activity and severity, anxiety, depressed mood, and quality of life contribute significantly to sleep disorders in SLE.