摘要
目的昼夜节律紊乱与自身免疫疾病具有相关性。本研究探讨类风湿关节炎(rheumatoid arthritis,RA)患者合并失眠这一昼夜节律紊乱的相关影响因素。方法采用多中心横断面临床调查方法,由风湿专科副主任医师及以上资质的专家经统一培训后进行问卷采集相关信息。调查问卷从睡眠严重程度指数和RA患者相关临床信息两个维度设计。在河北省的13家研究中心,按纳排标准筛选门诊或住院RA患者的相关信息,对患者失眠的相关因素进行比较和分析。结果共纳入RA患者181例。①一般资料:失眠者60例(33.1%),非失眠者121例,两者男女比均为1∶5;失眠者平均年龄大于非失眠者(P<0.01)。②共病:RA患者合并高血压、呼吸系统疾病、甲状腺疾病、骨质疏松或骨关节炎共病者,其失眠发生率高于无共病患者(P<0.05)。③临床用药:服用中(成)药/中药提取物的RA患者失眠发生率高于未用中药者(P=0.019)。④疾病状态:在疾病活动度和双手X线片的分级中,不同分级RA患者的失眠发生率差异有统计学意义(P<0.05)。⑤RA失眠与非失眠患者其生化和免疫学指标的差异无统计学意义(P>0.05)。结论RA患者存在较高比例的失眠,这一昼夜节律障碍与年龄、存在相关共病、中高疾病活动度及影像学分级有关。
Objective Circadian rhythm disorders links with autoimmune diseases.This study aims to explore the influencing factors for circadian rhythm disorders in patients with rheumatoid arthritis(RA)combined with insomni.Methods This was a multicenter cross-sectional clinical survey.Deputy chief physicians or above experienced in rheumatology were uniformly trained to collect relevant information through questionnaire surveys.The surveying questionnaire was designed from two dimensions of the insomnia severity index(ISI)and clinical information of RA patients.In 13 research centers in Hebei Province,RA outpatients or inpatients were screened according to inclusion and exclusion criteria.Relevant factors for insomnia in RA patients were compared and analyzed.Results A total of 181 RA patients were included in the analysis,including 60(33.1%)with insomnia,and 121 without it.The male-to-female ratio was 1∶5.The average age of RA patients with insomnia was significantly older than those without insomnia(P<0.01).RA patients with comorbidities like hypertension,respiratory diseases,thyroid diseases,osteoporosis,or osteoarthritis had a significantly higher incidence of insomnia than those without comorbidities(P<0.05).RA patients taking traditional Chinese herbal medicine/extracts of traditional Chinese medicine(TCM)had a significantly higher incidence of insomnia than those without TCM treatment(P=0.019).There was a significant difference in the incidence of insomnia among RA patients with varied disease activity scores and X-ray grading of hands(P<0.05).There were no significant differences in biochemical and immunological indicators between RA patients with or without insomnia(P>0.05).Conclusion A high proportion of RA patients suffer from insomnia,and the circadian rhythm disorder is associated with age,comorbidities,moderate-to-high disease activity,and radiographic grading.
作者
董泓
李振彬
马旭
罗亚萍
焦爱军
张旭飞
孙彩霞
Dong Hong;Li Zhenbin;Ma Xu;Luo Yaping;Jiao Aijun;Zhang Xufei;Sun Caixia(Department of Rheumatology and Immunology,Joint Logistics Support Force No.980 Hospital of the Chinese People’s Liberation Army,Shijiazhuang 050081,China;Department of Traditional Chinese Medicine,Joint Logistics Support Force No.980 Hospital of the Chinese People’s Liberation Army,Shijiazhuang 050081,China;Department of Rheumatology and Immunology,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,China;Department of Rheumatology and Immunology,the Second Affiliated Hospital of Xingtai Medical College,Xingtai 054002,China;Department of Rheumatology and Immunology,the Third Hospital of Shijiazhuang,Shijiazhuang 050011,China;Department of Rheumatology and Immunology,Affiliated Hospital of Hebei University,Baoding 071000,China)
出处
《临床荟萃》
CAS
2024年第10期882-888,共7页
Clinical Focus
基金
国家自然科学基金资助项目雷公藤择时治疗胶原诱导关节炎及其生物钟机制研究(81873301)。
关键词
关节炎
类风湿
入睡和睡眠障碍
昼夜节律紊乱
横断面调查
arthritis,rheumatoid
sleep initiation and maintenance disorders
circadian rhythm disorder
cross-sectional survey
