睡眠质量与复杂性外阴阴道假丝酵母菌病患病风险的相关性

Relationship between sleep quality and risk of complicated vulvovaginal candidiasis in women

目的分析睡眠质量与复杂性外阴阴道假丝酵母菌病(VVC)患病风险的相关性。方法采用横断面调查法,连续收集2021年1—6月在中南大学湘雅医院妇科门诊就诊的478例患者为研究对象,采用自制问卷收集患者年龄、婚姻状况、文化程度、家庭月收入、近2年居住地、生育史、生产次数、宫内节育器使用情况、流产次数、性生活频次、2个月内避孕药使用情况、2周内抗菌药物使用情况,采用广泛性焦虑障碍量表、患者健康问卷、健康问卷躯体症状群量表、匹兹堡睡眠质量指数收集患者焦虑、抑郁、躯体化症状、睡眠质量情况。以睡眠质量总分分组及各维度得分分组作为观察指标,构建3个logistic回归分析模型,探索睡眠质量与复杂性VVC之间的关系。结果复杂性VVC组已婚、中学及以下文化程度、近2年居住在农村、有生育史、生产次数≥3次、性生活频次≥1次/周、2周内未使用抗菌药物患者比例高于对照组(均P<0.05)。在不调整混杂因素时,与主观睡眠质量很好的患者相比,主观睡眠质量很差的患者患复杂性VVC的风险高6.73倍(OR=7.73,95%CI:3.22~18.55);调整混杂因素后,风险进一步提高到9.08倍(OR=10.08,95%CI:3.47~29.33)(均P<0.05)。与无睡眠障碍患者相比,轻度睡眠障碍患者患复杂性VVC的风险高97%(OR=1.97,95%CI:1.15~3.37);调整混杂因素后,患病风险仍然高97%(OR=1.97,95%CI:1.10~3.55)(均P<0.05)。结论主观睡眠质量差、轻度睡眠障碍可能与复杂性VVC患病风险相关。

Objective To investigate the correlation between sleep quality and risk of female complicated vulvovaginal candidiasis(VVC).Methods From January 2021 to June 2021,patients in the gynecological clinic of Xiangya Hospital of Central South University were continuously enrolled as the research objects using a cross-sectional survey.A self-made questionnaire was used to collect the age,marital status,education level,family monthly income,place of residence in the past two years,maternity history,number of births,intrauterine device,number of abortions,frequency of sex life,use of contraceptives within two months,use of antibacterial drugs within two weeks.Generalized Anxiety Disorder Scale,Patient Health Questionnaire,Health Questionnaire Somatic Symptom Group Scale,Pittsburgh Sleep Quality Index were used to collect patients′anxiety,depression,somatization symptoms,and sleep quality conditions.The total scores of sleep quality and the scores of each dimension were used as observation indicators.Three logistic regression analysis models were constructed to explore the relationship between sleep quality and complicated VVC groups.Results Patients in the complex VVC group were significantly higher in age,married,middle school education,rural area of residence in the last two years,birth history,number of births≥3,sexual frequency≥1/week,and no antibiotic use within two weeks compared to those in the control group(all P<0.05).Without adjusting for confounding factors,women with poor subjective sleep quality had a 6.73-fold increased risk(OR=7.73,95%CI:3.22-18.55)of complex VVC compared with those with good subjective sleep quality.After adjusting for confounding factors,the risk was further increased to 9.08 fold(OR=10.08,95%CI:3.47-29.33)(all P<0.05).Compared with women without sleep disorders,women with mild sleep disorders had a 97%increased risk of complex VVC(OR=1.97,95%CI:1.15-3.37).After adjusting for confounders,the risk remained 97%higher(OR=1.97,95%CI:1.10-3.55)(all P<0.05).Conclusion Poor subjective sleep quality and mild sleep disorder may be associated with the risk of complex VVC.