睡眠时长和睡眠质量对老年慢性阻塞性肺疾病预后的影响

Effect of Sleep Duration and Sleep Quality on Prognosis of Elderly Patients with Chronic Obstructive Pulmonary Disease

目的:探究睡眠时长和睡眠质量对老年慢性阻塞性肺疾病(COPD)预后的影响。方法:选取2019年5月至2023年5月福建省宁德市霞浦县三沙中心卫生院普通内科收治的老年COPD稳定期患者86例作为研究对象。随访6个月,依据急性加重情况分为急性加重组(急性加重发作次数≥1次)和稳定组。比较急性加重组和稳定组患者的临床资料。Logistic回归分析影响老年COPD急性加重的相关因素。制作受试者工作特征曲线(ROC),以曲线下面积(AUC)分析睡眠时长和睡眠质量对老年COPD急性加重的预测效能。结果:患者入院治疗后随访6个月,发生急性加重患者21例(24.42%)。急性加重组与稳定组性别、年龄、体质量指数(BMI)、吸烟、饮酒、病程、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)比较差异均无统计学意义(均P>0.05);急性加重组FEV1/FVC、睡眠时长均低于稳定组,睡眠质量评分高于稳定组(P<0.05)。多因素分析结果显示,FEV1/FVC、睡眠时长、睡眠质量均为影响老年COPD急性加重的独立因素(OR=3.466、2.147、2.251,P<0.05)。ROC分析显示,睡眠时长、睡眠质量对老年COPD急性加重的特异度为96.60%,高于单独睡眠时长、睡眠质量,且睡眠时长、睡眠质量二者联合预测老年COPD急性加重的AUC为0.911,高于其单独预测的AUC(Z=2.675,P=0.039;Z=2.986,P=0.032)。结论:睡眠时长、睡眠质量与老年COPD急性加重均存在一定的相关性,且睡眠时长联合睡眠质量对老年COPD急性加重进行预测的效能较高,可作为临床评估老年COPD急性加重的重要参考指标。

Objective:To explore the effects of sleep duration and sleep quality on the prognosis of elderly patients with chronic obstructive pulmonary disease(COPD).Methods:From May 2019 to May 2023,86 elderly patients with stable COPD admitted to the general internal medicine of Sansha Central Health Center,Xiapu County,Ningde City,Fujian Province,were selected as the study objects.The patients were followed up for 6 months and divided into acute plus recombination group(acute exacerbation≥1 time)and stable group.The clinical data of patients in acute plus recombination and stable group were compared.Logistic regression analysis was conducted to analyze the related factors affecting the acute exacerbation of COPD in the elderly.A receiver operating characteristic curve(ROC)was developed to analyze the predictive power of sleep duration and sleep quality in acute exacerbations using area under the curve(AUC).Results:Six months after admission,21 cases of acute exacerbation occurred,and the incidence of acute exacerbation was 24.42%.There were no significant differences in gender,age,body mass index(BMI),smoking,drinking,course of disease,forced expiratory volume(FEV 1)at the first second and forced vital capacity(FVC)between the acute and stable groups(P>0.05).FEV 1/FVC and sleep duration in acute plus recombinant group were lower than those in stable group,and sleep quality scores were higher than those in stable group(P<0.05).The results of multivariate analysis showed that FEV 1/FVC,sleep duration and sleep quality were all independent factors affecting the acute exacerbation of COPD in the elderly(OR=3.466,2.147,2.251,P<0.05).ROC analysis showed that the specificity of sleep duration and sleep quality on the acute exacerbation of COPD in the elderly was 96.60%.The AUC predicted by sleep duration and sleep quality alone was 0.911,which was higher than AUC predicted by sleep duration and sleep quality alone(Z=2.675,P=0.039;Z=2.986,P=0.032).Conclusion:Sleep duration and sleep quality are correlated with acute exacerbation of COPD in the elderly,and sleep duration combined with sleep quality can predict acute exacerbation of COPD in the elderly,and can be used as an important reference index for clinical evaluation of acute exacerbation of COPD in the elderly.