CAJ | 학술논문

目的分析类风湿关节炎(RA)患者的睡眠障碍及相关因素.方法对四川大学华西医院风湿科门诊就诊的71例RA患者进行睡眠质量及相关因素的问卷调查,包括匹兹堡睡眠质量指数(PSQI)、关节疼痛评分[采用视觉模拟尺(VAS)评价]、28个关节疾病活动指数(DAS28)、健康评估问卷(HAQ)、医院焦虑抑郁量表(HADS)、疲劳严重度量表(FSS)及一般情况,分析患者睡眠障碍特点.结果 71例RA患者中伴睡眠障碍者30例(42.3％).与无睡眠障碍者比,RA伴睡眠障碍者DAS28为3.90±1.12,关节疼痛评分为(5.03±2.63)分,PSQI为(10.87±2.42)分,HAQ为3.0(0.0,7.0)分,FSS为(39.17±14.02)分,HADS为(14.50±7.77)分,高于无睡眠障碍者[DAS28为2.92±1.92,关节疼痛评分为(2.41±1.84)分,PSQI为(4.29±1.85)分,HAQ为2.0(0.5,4.0)分,FSS为(29.63±16.12)分,HADS为(9.49±6.57)分],差异有统计学意义(P＜0.05).PSQI与DAS28、关节疼痛评分、HAQ、FSS、HADS呈正相关(r值分别为0.462、0.556、0.360、0.420、0.447,P值均＜0.01).logistic回归模型显示,关节疼痛评分是睡眠障碍的预测因素(P＜0.01).生物制剂组DAS28为2.86±1.39,PSQI为(5.90±4.24)分,关节疼痛评分为(2.15±2.30)分,HAQ为0.0(0.0,2.0)分,低于口服药物组[DAS28为3.52±1.10,PSQI为(8.53±3.78)分,关节疼痛评分为(4.05±2.46)分,HAQ为3.0(0.0,6.0)分],差异有统计学意义(P＜0.05).结论睡眠障碍在RA患者中发生率较高,并间接影响疾病活动及生活质量、抑郁、疲劳等身心健康;生物制剂在一定程度上能改善患者睡眠质量及功能状态.
목적 분석류풍습관절염(RA)환자적수면장애급상관인소.방법 대사천대학화서의원풍습과문진취진적71례RA환자진행수면질량급상관인소적문권조사,포괄필자보수면질량지수(PSQI)、관절동통평분[채용시각모의척(VAS)평개]、28개관절질병활동지수(DAS28)、건강평고문권(HAQ)、의원초필억욱량표(HADS)、피로엄중도량표(FSS)급일반정황,분석환자수면장애특점.결과 71례RA환자중반수면장애자30례(42.3％).여무수면장애자비,RA반수면장애자DAS28위3.90±1.12,관절동통평분위(5.03±2.63)분,PSQI위(10.87±2.42)분,HAQ위3.0(0.0,7.0)분,FSS위(39.17±14.02)분,HADS위(14.50±7.77)분,고우무수면장애자[DAS28위2.92±1.92,관절동통평분위(2.41±1.84)분,PSQI위(4.29±1.85)분,HAQ위2.0(0.5,4.0)분,FSS위(29.63±16.12)분,HADS위(9.49±6.57)분],차이유통계학의의(P＜0.05).PSQI여DAS28、관절동통평분、HAQ、FSS、HADS정정상관(r치분별위0.462、0.556、0.360、0.420、0.447,P치균＜0.01).logistic회귀모형현시,관절동통평분시수면장애적예측인소(P＜0.01).생물제제조DAS28위2.86±1.39,PSQI위(5.90±4.24)분,관절동통평분위(2.15±2.30)분,HAQ위0.0(0.0,2.0)분,저우구복약물조[DAS28위3.52±1.10,PSQI위(8.53±3.78)분,관절동통평분위(4.05±2.46)분,HAQ위3.0(0.0,6.0)분],차이유통계학의의(P＜0.05).결론 수면장애재RA환자중발생솔교고,병간접영향질병활동급생활질량、억욱、피로등신심건강;생물제제재일정정도상능개선환자수면질량급공능상태.
Objective To explore the characteristics of sleep disturbance and its related factors in patients with rheumatoid arthritis (RA).Methods A total of 71 patients with RA in Department of Rheumatology Huaxi Hospital have completed the following questionnaires, including Pittsburgh sleeping quality index (PSQI), visual analogue scale (VAS), disease activity score in 28 joints (DAS28), health assessment questionnaire (HAQ), hospital anxiety and depression scale (HADS), fatigue severity scale (FSS) and a self-designed general status questionnaire.Results The prevalence of sleep disturbance was 42.3％ (30/71) in rheumatoid arthritis patients (68.4％).The scores of DAS28, VAS, PSQI, HAQ, FSS and HADS in patients with sleep disturbance were significantly higher than those in patients with good sleep, which were respectively 3.90 ± 1.12 vs 2.92 ± 1.92, (5.03 ± 2.63) scores vs (2.41 ± 1.84) scores, (10.87 ± 2.42) scores vs (4.29 ± 1.85) scores, 3.0 (0.0, 7.0) scores vs 2.0 (0.5,4.0) scores, (39.17 ±14.02) scores vs (29.63 ± 16.12) scores, (14.50 ±7.77) scores vs (9.49 ±6.57) scores (P ＜ 0.05 in all scales).According to the results of Pearson correlation analysis, PSQI had significantly positive correlation with DAS28 (r =0.462, P ＜ 0.01), VAS (r =0.556, P ＜ 0.01), HAQ (r =0.360, P ＜ 0.01), FSS(r =0.420, P ＜ 0.01) and HADS (r =0.447, P ＜ 0.01) respectively.The logistic regression analysis indicated that VAS was a predictor for poor sleep quality (P ＜ 0.01).The patients receiving biological agents had significantly (P ＜ 0.05) lower scores of DAS28 (2.86±1.39 vs 3.52 ± 1.1 0), PSQI [(5.90 ± 4.24) scores vs (8.53 ± 3.78) scores], VAS(2.15 ± 2.30 vs 4.05 ± 2.46), HAQ [0.0 (0.0, 2.0) scores vs 3.0(0.0,6.0) scores] compared to those taking oral drugs.Conclusion High prevalence of sleep disturbance in patients with RA is noted, which indirectly influences the activity of disease, quality of life, depression, fatigue and other physical and mental health.Biological agents can partly improve the sleep disturbance and functional status.