| 应奇素,毛勇,朱炜丹,谢祥成,费晓,王鸣,程明,杨秀.维持性血液透析患者睡眠质量与轻度认知功能障碍的相关性研究[J].浙江中西医结合杂志,2022,32(3): |
| 维持性血液透析患者睡眠质量与轻度认知功能障碍的相关性研究 |
| Correlation analysis between sleep quality and mild cognitive impairment in maintenance hemodialysis patients |
| 投稿时间：2021-05-11 修订日期：2021-06-29 |
| DOI： |
| 中文关键词: 血液透析 认知功能 睡眠质量 危险因素 相关性 |
| 英文关键词:Hemodialysis Cognitive function Sleep quality Risk factors Correlation |
| 基金项目: |
|
| 摘要点击次数: 681 |
| 全文下载次数: 15 |
| 中文摘要: |
| 目的：探讨维持性血液透析患者(maintenance hemodialysis, MHD)轻度认知功能障碍(mild cognitive impairment, MCI)的危险因素及睡眠质量对MHD患者认知功能的影响。
方法：选取杭州市2家血液透析中心MHD患者进行横断面调查研究，分别采用中文版蒙特利尔认知量表(Montreal Cognitive Assessment, MoCA)和匹兹堡睡眠质量问卷(Pittsburgh Sleep Quality Index, PSQI)评估MHD患者的认知功能和睡眠质量。根据MoCA评分将患者分为轻度认知功能障碍组(MCI组)和认知功能正常组(NC组)，比较两组患者一般情况、睡眠质量、透析情况及生化指标等差异是否存在统计学意义，采用Logistic回归分析探讨MHD患者MCI的危险因素，Pearson相关系数法分析睡眠障碍不同维度与MCI之间的相关性。
结果：本研究纳入173例MHD患者，MCI组117例(67.6%), NC组56例(32.4%)。Logistic回归分析结果显示，睡眠质量(PSQI≥11)、文化程度 (小学及以下)、饮酒史、血透尿素清除率 (KT/V＜1.42)、血磷 (≥1.78 mmol/L)是MHD患者MCI的相关危险因素(P<0.05)。PSQI评分与MoCA评分呈负相关(r=-0.313, P＜0.05)，即睡眠质量越差(PSQI评分越高)，认知功能越差(MoCA评分越低)；且睡眠潜伏期(入睡时间)、睡眠效率(有效睡眠)、睡眠紊乱、日间功能障碍的评分与MoCA评分呈负相关(P＜0.05)。
结论：MHD患者的MCI不仅与文化程度、饮酒史、KT/V及血磷等因素相关，睡眠质量差也是其独立危险因素；睡眠质量与认知功能呈正相关，睡眠质量越差，认知功能损害越严重。 |
| 英文摘要: |
| Objective: To investigate the risk factors of mild cognitive impairment in maintenance hemodialysis (MHD) patients and explore the correlation between mild cognitive impairment and sleep disorder in the MHD patients.
Methods: A cross-sectional survey of MHD patients from 2 hemodialysis centers in Hangzhou was conducted. The general condition and clinical data of the patients were collected. The Chinese version of Montreal Cognitive Assessment (MoCA) and Pittsburgh sleep quality index (PSQI) were used to evaluate cognitive function and sleep quality in MHD patients respectively. MHD patients were divided into mild cognitive impairment group (MCI group) and normal cognitive function group (NC group) according to the MoCA score. The general conditions, sleep quality, dialysis conditions and biochemical indicators of the two groups were compared. The risk factors of mild cognitive impairment in patients with MHD were analyzed using binary logistic regression analysis. Pearson correlation coefficient method was used to analyze the correlation between different components of sleep disorder and cognitive dysfunction.
Results: A total of 173 MHD patients with mild cognitive impairment of 117 cases (67.6%) were included in the study. The results of binary logistic regression analysis showed that poor sleep quality (PSQI≥11), low education level (primary school and below), drinking history, low hemodialysis urea clearance rate (KT/V＜1.42), hyperphosphatemia (≥1.78 mmol) /L) were related risk factors for mild cognitive impairment in MHD patients (P<0.05), and its OR value (95% CI) are: 1.953 (0.823～4.629), 0.169 (0.067～0.430), 2.237 (1.004～ 4.975), 0.25 (0.111～0.564), 2.95 (1.210～7.194) respectively. The PSQI score was negatively correlated with the MoCA score (r=-0.313, P＜0.05), which indicated that the worse the sleep quality (the higher the PSQI score), the worse the cognitive function (the lower the MoCA score). And sleep latency (time to fall asleep), habitual sleep efficiency (effective sleep), sleep disturbances, and daytime dysfunction scores were negatively correlated with MoCA scores (P<0.05).
Conclusions: Mild cognitive dysfunction in MHD patients is not only related to factors such as education level, drinking history, KT/V and hyperphosphatemia, poor sleep quality is also an independent risk factor. Sleep quality is positively correlated with cognitive function. The worse the quality of sleep, the more severe the impairment of cognitive function. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
