维持性血液透析患者营养不良对睡眠障碍的影响

Effect of Malnutrition on Sleep Disorders in Maintenance Hemodialysis Patients

目的:分析维持性血液透析(MHD)患者营养不良对睡眠障碍的影响。方法:本横断面研究选取2022-11-2023-03的137例MHD患者,依据匹兹堡睡眠质量指数(PSQI)量表评分,分为睡眠障碍组(PSQI>5,n=88)与非睡眠障碍组(PSQI≤5,n=49)。比较两组患者综合主观性营养评估(SGA)、人体成分分析之相位角(PA)和其它资料、指标如血肌酐等的差异,采用Spearman相关分析及Logistic回归模型分析营养不良与睡眠障碍的关系。结果:与非睡眠障碍组比较,睡眠障碍组血肌酐降低、PA<4.3占比和SGA评估营养不良占比升高(P<0.05或<0.01);相关分析显示血肌酐水平降低与PQSI值升高明显呈负相关(r=-0.135,P<0.05),PA<4.3占比增加和SGA评估营养不良占比增加与PSQI值升高显著正相关(r=0.207、0.235,均P<0.05);多因素Logistics回归分析提示,血肌酐降低、PA<4.3占比和SGA评估营养不良占比增加是MHD患者睡眠障碍的独立危险因素(P<0.05)。结论:MHD患者的营养不良明显影响其睡眠质量。

Objective:To analyze the effect of malnutrition on sleep disorders in maintenance hemodialysis(MHD)patients.Method:In this cross-sectional study,137 MHD patients were selected from November 2022 to March 2023 and divided into sleep disorder group(PSQI>5,n=88)and non-sleep disorder group(PSQI≤5,n=49)based on the pittsburgh sleep quality index(PSQI)scale score.The differences in comprehensive subjective nutritional assessment(SGA),phase angle(PA)of body composition analysis and other information and indicators such as blood creatinine were compared between the two groups,and the relationship between malnutrition and sleep disorders was analyzed by using Spearman's correlation analysis and Logistic regression model.Results:Compared with the non-sleep-disordered group,the sleep-disordered group had lower blood creatinine,higher percentage of PA<4.3,and higher percentage of SGA-assessed malnutrition(P<0.05 or<0.01).Correlation analyses showed that lower blood creatinine levels were significantly negatively correlated with higher PQSI values(r=-0.135,P<0.05),and that increased percentage of PA<4.3 and increased percentage of SGA-assessed malnutrition were significantly positively correlated with PSQI values were significantly positively correlated with elevated PSQI values(r=0.207,0.235,both P<0.05).Multifactorial logistic regression analysis suggested that decreased blood creatinine,increased percentage of PA<4.3,and increased percentage of SGA-assessed malnutrition were independent risk factors for sleep disorders in MHD patients(P<0.05).Conclusion:Malnutrition in MHD patients significantly affects their sleep quality.