炎症性肠病与睡眠障碍的相关性研究

Correlation between inflammatory bowel disease and sleep disorders

目的探讨炎症性肠病(inflammatory bowel disease,IBD)患者主观睡眠不良与疾病活动度及相关炎症指标之间的关系。方法选取2018年1月至2019年3月于武汉大学人民医院消化内科住院治疗的116例IBD患者(54例CD和62例UC)为研究对象,另选取120名健康体检者为对照组;收集纳入对象的一般临床信息及ESR、CRP、NLR等相关疾病检查结果,分别采用CD活动指数(CDAI)与UC Mayo评分进行疾病活动度的评分,同时对所有纳入对象采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)进行问卷调查。结果IBD组PSQI评分显著高于对照组(P<0.05);CD与UC患者中不同临床活动期间PSQI得分差异均有显著统计学意义(P<0.01);CD的PSQI最佳临界值为7.5分(灵敏度为67%,特异度为87%),诊断价值AUC=0.794,95%CI:0.712~0.876,UC的PSQI最佳临界值为7.5分(灵敏度为66%,特异度为87%),诊断价值AUC=0.843,95%CI:0.784~0.903;CD与UC患者血清ESR、CRP、NLR水平与其PSQI得分均呈正相关(ESR:r=0.519、0.54;CRP:r=0.573、0.584;NLR:r=0.425、0.382;P<0.01)。结论IBD患者的疾病活动度与其睡眠障碍之间存在密切关联,PSQI评分可以作为评估患者炎症活动性的另一种非侵入性检测方法。

Objective To investigate the relationship of subjective sleep dysfunction with disease activity and related inflammatory markers in patients with inflammatory bowel disease(IBD).Methods A total of 116 patients(54 CD and 62 UC)with IBD admitted to the Department of Gastroenterology,Renmin Hospital of Wuhan University from Jan.2018 to Mar.2019 were enrolled.Another 120 healthy subjects were selected as the control group.The general clinical information of the included subjects was collected after administration.ESR,CRP,NLR and other related disease examination results were scored by CD activity index(CDAI)and UC Mayo score,respectively.The Pittsburgh sleep quality index(PSQI)was used for all subjects’questionnaire.Results The PSQI score of the IBD group was significantly higher than that of the control group(P<0.05).The PSQI scores of CD and UC patients were significantly different during different clinical activities(P<0.01).The optimal threshold of CD’s PSQI score was 7.5(sensitivity:67%,specificity:87%),and diagnostic value was AUC=0.794,95%CI:0.712-0.876,UC was 7.5(sensitivity:66%,specificity:87%),the diagnostic value was AUC=0.843,95%CI:0.784-0.903;serum ESR,CRP,NLR levels were positively correlated with PSQI scores in patients with CD and UC(ESR:r=0.519,0.54;CRP:r=0.573,0.584;NLR:r=0.425,0.382;P<0.01).Conclusion There is a close relationship between clinically active and sleep disorders in patients with IBD.The PSQI score can be used as a non-invasive method for assessing inflammatory activity in IBD patients.