摘要
目的比较RA患者和健康对照人群的睡眠质量，评估RA患者睡眠质量与疾病活动度的相关性。方法收集2015年1月至2017年6月于山西医科大学第二医院风湿免疫科住院的160例RA患者，同时纳入90名年龄、性别相匹配的健康人群作对照组。采用匹兹堡睡眠质量指数（PSQI）做对照研究，性别、年龄、治疗药物、ESR、CRP、DAS28、视觉模拟评分法（VAS）和贝克抑郁量表第2版（BDI-Ⅱ）作协变量分析。依据DAS28评分高低，分析RA患者睡眠质量与疾病活动度的关系。结果RA患者中睡眠障碍发生的比例68.1%（109/160）高于对照组18.9%（17/90）。RA组中PSQI总分为（7.2±3.2）分高于健康对照组的（3.1±2.8）分，二者比较差异有统计学意义（t=10.636，P〈0.05）。RA组中，伴有睡眠障碍者（PSQI〉5分）的平均年龄（56±12）岁高于不伴睡眠障碍者（PSQI≤5分）的平均年龄（48±9）岁。伴有睡眠障碍者VAS评分（5.8±2.2）分和BDI-Ⅱ评分（25.1±9.1）均高于不伴睡眠障碍者VAS评分（2.1±2.1）分和BDI-Ⅱ评分（14.2±6.6）分，差异有统计学意义（tVAS=10.271，tBDI-Ⅱ=8.536；P〈0.05）。DAS28评分与BDI-Ⅱ评分有相关性（r=0.382，P=0.001），PSQI与BDI-Ⅱ评分有相关性（r=0.312，P=0.001）。主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍和PSQI总分均随着RA活动度的增加而增加。结论RA患者中睡眠障碍的发生率较健康人群高。当RA病情高度活动时，其睡眠障碍发生率明显增高。
ObjectiveTo assess the correlation between sleep quality and disease activity in rheumatoid arthritis （RA） patients by comparing the sleep quality of RA patients with healthy control group.MethodsOne hundred and sixty cases of RA patients who were hospitalized in the Second Hospital of Shanxi Medical University from January 2015 to June 2017 were included into this study, and 90 age and gender matched healthy people were selectedas control group. Age, sex, therapeutic drugs, Pittsburgh Sleep Quality Index （PSQI）, serum erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, the 28-joint Disease Activity Score （DAS28）, Visual Analogue Score （VAS） and Beck Depression Inventory second edition （BDI-Ⅱ） were detected and compared. According to the DAS28 scores, the relationship between the sleep quality of RA patients and the degree of disease activity was analyzed.ResultsOne hundred and nine cases （68.1%） with sleep disorders in the RA group, which was higher than that in the healthy control group, in which 17 cases （18.9%） had sleep disorder. The total scores of the PSQI in the RA group were higher than those in the healthy control group, which were （7.2±3.2） scores vs （3.1±2.8） scores （t=10.636, P〈0.05） respectively. In the RA group, the average age of patients with sleep disorders （PSQI〉5） （56±12） years was higher than that of patients without sleep disorders （48±9） years （PSQI≤5）. The VAS and BDI-Ⅱ score in RA patients with sleep distur-bance were higher than those with non-sleep disturbance, which were （5.8±2.2） scores vs （25.1±9.1） scores vs （2.1±2.1） scores vs （14.2±6.6） scores （P〈0.05） respectively. According to the results of Pearson correlation an-alysis, DAS28 was significantly positively correlated with BDI-Ⅱ （r=0.382, P=0.001）, PSQI wassignificantly positively-correlated with BDI-Ⅱ （r=0.312, P=0.001）. Subjective sleep quality, sleep time, sleep efficiency, sleep disorder, daytime dysfunction and the PSQI total score increased with the increase of RA activity.ConclusionThe incidence of sleep disturbance in RA patients is higher than that in the normal population. The incidence of sleep disturbance, increases significantly accompanied by high disease activities in RA patients.
作者
石磊
韩晓蕾
石蕊
牛红青
李小峰
王彩虹
Shi Lei;Hart Xiaalei;Shi Rui;Niu Hongqing;Li Xiaofeng;Wang Caihong(Department of Rheumatology and Immunology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Mental Health,the Second Hospital of Shanxi Medical University,Taiyuan 030001,Chin)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2018年第7期435-439,共5页
Chinese Journal of Rheumatology
基金
国家自然科学基金（81471618/H1008）
山西省回国留学人员科研资助项目（2016-124）
关键词
关节炎
类风湿
睡眠障碍
疾病活动度
Rheumatoid arthritis
Sleep disorder
Disease activity
