终末期肾脏病患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系研究

Influencing Factors of Sleep Quality and Its Relationship with Quality of Life,Anxiety and Depression in Patients with End-stage Renal Disease

目的:探讨终末期肾脏病(ESRD)患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系。方法:选取2018年3月~2019年12月期间我院收治的ESRD患者198例为研究对象。患者睡眠质量采用匹兹堡睡眠指数量表(PSQI)评价。采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评估患者焦虑、抑郁状态。采用肾病生活质量评价量表(KDQOL-SF1.2)评价患者生活质量。分析ESRD患者睡眠质量的影响因素,并分析睡眠质量与生活质量、焦虑抑郁的相关性。结果:ESRD患者中约有93例发生睡眠障碍,睡眠障碍发生率为46.97%(93/198),并将其纳入睡眠障碍组,剩余的105例纳入非睡眠障碍组。非睡眠障碍组KDQOL-SF 1.2评分高于睡眠障碍组,SAS评分、SDS评分则低于睡眠障碍组(P<0.05)。单因素分析结果显示,两组年龄、透析龄、血红蛋白、甲状旁腺激素(iPTH)、血肌酐(Scr)、血钙、血磷比较差异显著(P<0.05),两组性别、配偶、经济收入、文化程度、血清白蛋白、尿素氮(BUN)比较差异无统计学意义(P>0.05)。多重线性回归方程结果显示,年龄、透析龄、血红蛋白、iPTH、Scr、血钙、血磷均是ESRD患者睡眠障碍的影响因素(P<0.05)。PSQI评分与SAS评分、SDS评分均呈正相关,与KDQOL-SF 1.2评分呈负相关(P<0.05)。结论:ESRD患者睡眠障碍的发生率高,年龄、透析龄、血红蛋白、iPTH、Scr、血钙、血磷均是ESRD患者睡眠质量的影响因素,同时其睡眠质量与生活质量、焦虑抑郁具有一定的相关性。

Objective:To investigate the influencing factors of sleep quality and its relationship with quality of life,anxiety and depression in patients with end-stage renal disease(ESRD).Methods:198 cases of patients with ESRD in our hospital from March 2018 to December 2019 were selected as the research objects.The sleep quality of patients were evaluated by Pittsburgh sleep quality index(PSQI).Self rating Anxiety Scale(SAS)and self rating Depression Scale(SDS)were used to evaluate the anxiety and depression of patients.The quality of life of patients was evaluated by the kidney disease quality of life scale(KDQOL-SF 1.2).The influencing factors of sleep quality in patients with ESRD were analyzed,and correlation between sleep quality and quality of life,anxiety and depression wrre analyzed.Results:Among the patients with ESRD had 93 cases developed sleep disorders,the incidence rate of sleep disorders was 46.97%(93/198),which were included in the sleep disorders group,and the remaining 105 cases were included in the non-sleep disorders group.The KDQOL-SF 1.2 score of non-sleep disorder group was higher than that of sleep disorder group,SAS score and SDS score were lower than that of sleep disorder group(P<0.05).Univariate analysis showed that there were significant differences in age,dialysis age,hemoglobin,parathyroid hormone(iPTH),serum creatinine(Scr),serum calcium and serum phosphorus between the two groups(P<0.05),but there were no significant differences in gender,spouse,economic income,education level,serum albumin and urea nitrogen(BUN)between the two groups(P>0.05).The results of multiple linear regression equation showed that age,dialysis age,hemoglobin,iPTH,SCR,serum calcium and serum phosphorus were independent influencing factors of sleep disorder in patients with ESRD(P<0.05).PSQI score were positively correlated with SAS score and SDS score,and negatively correlated with KDQOL-SF 1.2 score(P<0.05).Conclusion:The incidence rate of sleep disorders in patients with ESRD is high.Age,dialysis age,hemoglobin,iPTH,Scr,serum calcium and serum phosphorus are independent influencing factors of sleep disorders in patients with ESRD,At the same time,its sleep quality is related to quality of life,anxiety and depression.