摘要
目的分析2型糖尿病（T2DM）患者的睡眠质量对血糖控制达标的影响及相关因素。方法选取2011年6月至2012年2月在中日友好医院内分泌科住院的T2DM患者200例为研究对象，采用匹兹堡睡眠质量指数（PSQI）量表调查T2DM患者的睡眠质量。以糖化血红蛋白（HbAlc）〈7．0％作为血糖控制达标；以Zung氏抑郁自评量表（SDS）了解患者精神状况，SDS≥50分为抑郁状态；以PSQI≥7分为睡眠障碍，将患者分为无睡眠障碍组（88例）和睡眠障碍组（112例）；并结合临床资料进行分析和比较。计量资料采用独立样本t检验，计数资料采用卡方检验，与睡眠障碍、血糖达标的相关性分析采用多元logistic回归分析。结果与无睡眠障碍组相比，睡眠障碍组年龄、HbAlc、血糖（空腹、0．5h,2h）、总胆固醇、甘油三酯、PSQI评分、SDS评分、抑郁发生率明显升高（t=-19．49～-1．99，，=9．931，均P〈0．05）；C肽（空腹、0．5h）、体质指数（BMI）明显偏低（t=2．07、2．14、2．35，均P〈0．05）。PSQI评分〈5分组、5～7分组、7—9分组和≥9分组的血糖达标率分别为27．9％、19．6％、10．0％和8．6％，随着PSQI评分升高，血糖达标率呈逐渐下降的趋势。多元logistic回归分析结果显示：睡眠障碍与年龄、男性、HbAlc≥7．0％及抑郁呈正相关，与BMI负相关（OR=1．04、2．38、2．98、2．14、0．89，均P〈0．05）。HbAlct〉7．0％与睡眠障碍及2h血糖呈正相关，与胰岛素治疗呈负相关（OR=2．81、1．21、0．33，均P〈0．05）。结论T2DM患者普遍存在睡眠障碍，其与高血糖存在着交互影响，并造成心理健康问题。应重视对T2DM患者的睡眠质量管理和血糖控制，以改善睡眠和有效提高血糖达标率。
Objective To investigate the effect of sleep quality on glycemic control and relevant factors involved in subjects with type 2 diabetic mellitus（T2DM）. Methods A total of 200 inpatients with T2DM were enrolled in this study. Each patient completed Pittsburg Sleep Quality Index （PSQI） questionnaire. The glycemic control target was 〈 7%. All patients were evaluated by Zung Self-rating Depression Scale （SDS） for the mental status, the score of SDS ≥ 50 was defined as a depressive state. Patients were divided into two groups ： non-sleep disorder group （ n = 88 ） and sleep disorder group （ n = 112） according to PSQI score ≥7 which was defined as the sleep disorder. The clinical characteristics of two groups were compared and analyzed. Results The incidence of sleep disorder was 56% in the overall population. In the sleep disorders group, Age, hemoglobin A, glycosylated （HbAlc）, fasting plasma glucose, 0. 5-hour as well as 2-hour postprandial plasma glucose, fasting serum total cholesterol, triglycerides,the score of SDS and the incidence of depression were significantly greater （t = -19.49 - - 1.99, X2 = 9. 931, all P 〈 0.05 ）, whereas fasting C-peptide, 0. 5-hour postprandial C-peptide and body mass index （BMI） were significantly lower （t =2.07,2. 14,2. 35,all P 〈0. 05） than those of the non-sleep disorder group. Glycemic control target rate of PSQI 〈 5 group, PSQI I〉 5 to 7 group, PSQI ≥ 7 to 9 group and PSQI~〉9 group was 27. 9%, 19. 6%, 10. 0% and 8. 6%, respectively. Patients with a higher score ofPSQI were less likely to reach glycemic targets （ P 〈 0.05 ）. Multiple logistic regression analysis indicated that sleep disorders was positively correlated with increased age, male, HbAlc and depression, however, sleep disorders was negatively related to BMI （ OR = 1.04, 2. 38, 2. 98, 2. 14, 0. 89, respectively, all P 〈 0. 05）. There was a positive association between sleep disorders, 2-hour postprandial plasma glucose and HbAle≥7%, however, HbAlc≥
出处
《中华糖尿病杂志》
CAS
CSCD
2013年第4期221-225,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
关键词
糖尿病
2型
睡眠质量
糖化血红蛋白
Diabetic mellitus, type 2
Sleep quality
Hemoglobin A, glycosylated
