摘要
目的调查行持续非卧床腹膜透析(CAPD)治疗患者的睡眠质量状况,了解影响行CAPD患者睡眠质量的相关因素。方法采集96例在门诊行CAPD患者的一般资料、发病原因和临床生化指标,计算肌酐清除率(CCr)、尿素清除指数(Kt/V)以评估残余肾功能和CAPD充分性,采用匹兹堡睡眠质量指数量表(PSQI)、Hamilton焦虑等级量表(HAMA)、Hamilton抑郁等级量表(HAMD)、主观综合性营养评估(SGA)调查患者的睡眠质量及其相关因素分析。结果所有患者的平均PSQI评分为(8.21±3.48)分,其中PSQI评分≥5分(睡眠较差组)41例,PSQI评分<5分(睡眠良好组)55例。睡眠障碍的总体发生率为42.7%(41/96)。睡眠良好组的男性和有社会保险的构成比、血红蛋白(Hb)水平均显著高于睡眠较差组(P值均<0.05),CAPD龄显著短于睡眠较差组(P<0.01),焦虑、抑郁、轻/中度营养不良的发生率,全段甲状旁腺素(iPTH)水平均显著低于睡眠较差组(P值分别<0.05、0.01)。多元线性逐步回归分析结果显示,PSQI评分与CAPD龄(β=0.371,P=0.016)、iPTH水平(β=0.258,P=0.037)、HAMA评分(β=0.279,P=0.034)、HAMD评分(β=0.325,P=0.023)呈正相关,与Hb水平(β=-0.236,P=0.018)、SGA评分(β=-0.181,P=0.042)呈负相关。结论行CAPD患者中睡眠障碍发病率较高,合并睡眠障碍的患者焦虑、抑郁、营养不良的发生率高,行CAPD患者的睡眠质量与患者的年龄、社会支持、经济收入、受教育程度、CAPD充分性不相关,与CAPD龄、Hb水平、iPTH水平、焦虑抑郁状态、营养状况有相关性,临床上应加强认识并有效干预可助于改善患者睡眠质量。
Objective To assess sleep quality and correlation factors in patients with continuous ambulatory peritoneal dialysis （CAPD）. Methods A total of 96 CAPD outpatients were recruited in the study. Demographic data, primary disease and clinical biochemical indices were collected. Creatinine clearance rate （CCr） and urea kinetics （Kt/V） were calculated to evaluate residual renal function and urea clearance. A set of questionnaires were used to evaluate sleep quality and its correlation factors, including Pittsburgh sleep quality index （PSQI）, Hamilton anxiety rating scale （HAMA）, Hamilton depression rating scale （HAMD） and subjective global assessment （SGA）. Results The average score of PSQI of the 96 recruited patients was 8.21 --. 3.48, and 41 patients （42.7%） suffered from sleep disorder （score of PSQI≥5）. Patients with poor sleep quality had longer peritoneal dialysis （PD） duration （ P〈 0. 01 ）, lower hemoglobin （Hb） level （ P〈 0. 05）, higher immunoreactive parathyroid hormone （iPTH） level and higher incidence of anxiety, depression and malnutrition （P 〈0.05, P〈0.01）. Males and patients with social insurance had lower proportion in poor sleep quality group （P 〈0.05）. Multiple linear stepwise regression analysis showed that PSQI score was positively correlated with PD duration （/3=0.371, P=0.016）, iPTH （β=0.258, P=0.037）, HAMA score （β=0.279, P=0.034） and HAMD score （β = 0. 325, P = 0. 023）, and negatively correlated with Hb level （β= -- 0. 236, P = 0. 018） and SGA score （β = -0. 181, P = 0. 042）. Conclusion Patients on CAPD have high incidence rate of sleep disorder. OAPD patients with poor sleep quality have high incidence of anxiety, depression and malnutrition. Sleep quality is correlated with PD duration, Hb level, iPTH level, anxiety, depression and nutritional status, but not with age, social support, income, educational level, COr level or Kt/V level in CAPD patients.
出处
《上海医学》
CAS
CSCD
北大核心
2014年第9期798-801,共4页
Shanghai Medical Journal
关键词
持续非卧床腹膜透析
睡眠
焦虑
抑郁
营养
Continuous ambulatory peritoneal dialysis
Sleep
Anxiety
Depression
Nutrition
