心房颤动患者睡眠质量与生活质量的相关性分析

胡光玲; 乔昕悦; 张林虹; 于漫; 黄莉莉; 崔芳芳; 杨巧芳

doi:10.16766/j.cnki.issn.1674-4152.001720

心房颤动患者睡眠质量与生活质量的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.001720

河南省人民医院心脏中心华中阜外医院郑州大学华中阜外医院心内科，河南郑州 450003

基金项目:

河南省医学科技攻关计划项目 SB201901100

详细信息

通讯作者:
杨巧芳，E-mail：honglelv@163.com

中图分类号: R541.7
计量
- 文章访问数: 187
- HTML全文浏览量: 134
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2020-06-11
- 网络出版日期: 2022-02-19

Correlation analysis of sleep quality and life quality in patients with atrial fibrillation

Department of Cardiology, Henan Provincial People's Hospital Heart Center, Huazhong Fuwai Hospital, Huazhong Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China

摘要

摘要: 目的采用评分量表评估心房颤动患者的睡眠质量和生活质量，分析心房颤动患者睡眠质量与生活质量的相关性。方法选取郑州大学华中阜外医院心内科2019年3月—2020年3月收治的心房颤动患者96例为研究对象，采用匹兹堡睡眠质量指数量表(PSQI)对患者睡眠质量状况进行评估，采用房颤特异生活质量量表(AFEQT)对患者生活质量状况进行评估，根据PSQI评分将96例患者分为睡眠障碍组和非睡眠障碍组，比较2组患者睡眠质量和生活质量，并分析二者之间的相关性。结果 96例患者中，睡眠障碍组患者共62例，占64.58%，非睡眠障碍组共34例，占35.42%；睡眠障碍组患者主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、睡眠药物使用以及日间功能障碍评分及PSQI总分均明显高于非睡眠障碍组患者(均P < 0.01)；睡眠障碍组患者症状严重程度、治疗焦虑、日常活动及AFEQT总分均明显低于非睡眠障碍组患者(均P < 0.05)，2组患者治疗满意度评分比较差异无统计学意义(P>0.05)；经Pearson线性分析显示，PSQI总分与AFEQT量表中的症状严重程度、日常活动、治疗焦虑及AFEQT总分呈负相关性(均P < 0.05)。结论心房颤动患者多数存在睡眠障碍，伴有睡眠障碍的心房颤动患者生活质量显著低于无睡眠障碍患者，心房颤动患者的睡眠质量与生活质量之间密切相关，临床治疗房颤时应注重患者的睡眠质量状况，采取措施改善睡眠质量进而提高心房颤动患者的生活质量。
- 心房颤动 /
- 睡眠质量 /
- 生活质量 /
- 相关性
Abstract: Objective To evaluate the sleep quality and life quality of patients with atrial fibrillation (AF) using the score scale, and analyse the correlation between sleep quality and life quality of patients with AF. Methods A total of 96 cases of AF admitted in the Heart Medicine Department from March 2019 to March 2020 were collected as the research subjects. The Pittsburgh sleep quality index scale (PSQI) was used to evaluate patients' sleep quality, and the specific quality of life scale (AFEQT) was performed in patients with AF to evaluate quality of life. The patients were divided into the sleep disorder and non-sleep disorder groups on the basis of their PSQI scores. Sleep quality and quality of life were compared between the two groups, and their correlation was analysed. Results Amongst the 96 patients, 62 (64.58%) were in the sleep disorder group, and 34 (35.42%) were in the non-sleep disorder group. Subjective sleep quality, sleep time, sleep efficiency, sleep disturbance, sleep medication use, daytime dysfunction score and total PSQI score of patients in the sleep disorder group were significantly higher than those in the non-sleep disorder group (all P < 0.01). The severity of symptoms, treatment anxiety, daily activities and total AFEQT scores of patients in the sleep disorder group were significantly lower than those in the non-sleep disorder group (all P < 0.05). Moreover, no statistical significance in the scores of treatment satisfaction was found between the two groups (P>0.05). Pearson linear analysis showed that the total PSQI score was negatively correlated with the symptom severity, daily activities, treatment anxiety and total AFEQT score in the AFEQT scale (all P < 0.05). Conclusion AF is mostly associated with sleep disorders. The quality of life of AF patients with sleep disorders is significantly lower than that of patients without sleep disorders. The sleep quality of patients with AF is closely related to the quality of life. Clinical treatment should consider the sleep quality status of AF patients, and measures should be taken to improve the sleep quality and quality of life of patients with AF.
- Atrial fibrillation /
- Sleep quality /
- Quality of life /
- Correlation

HTML全文

表 1 2组心房颤动患者一般资料比较[例(%)]

组别	例数	年龄(x±s，岁)	性别		心率(x±s，次/min)	高血压病史	冠心病史	阻塞性睡眠呼吸暂停
组别	例数	年龄(x±s，岁)	男性	女性	心率(x±s，次/min)	高血压病史	冠心病史	阻塞性睡眠呼吸暂停
睡眠障碍组	62	65.84±2.85	36(58.06)	26(41.94)	78.95±2.83	41(66.13)	34(54.84)	7(11.29)
非睡眠障碍组	34	64.95±2.94	21(61.76)	13(38.24)	77.93±2.84	21(61.76)	16(47.05)	2(5.88)
统计量		1.447^a	0.125^b		1.687^a	0.183^b	0.533^b	0.756^b
P值		0.151	0.724		0.095	0.669	0.466	0.385

组别	例数	阵发性房颤	1年内心房颤动就诊次数(x±s，次)	城市职工医保	农村合作医疗	正在接受华法林治疗	治疗后房颤复律	伴有焦虑、抑郁情绪
睡眠障碍组	62	37(59.68)	2.81±0.23	37(59.68)	21(33.87)	27(43.55)	11(17.74)	13(20.97)
非睡眠障碍组	34	22(64.71)	2.78±0.25	22(64.71)	8(23.53)	15(44.12)	7(20.59)	5(14.71)
统计量		0.234^b	0.593^a	0.234^b	1.114^b	0.003^b	0.117^b	0.565^b
P值		0.628	0.555	0.628	0.291	0.957	0.733	0.452
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 2 2组心房颤动患者PSQI评分比较(x±s，分)

组别	例数	主观睡眠质量	入睡时间	睡眠时间	睡眠障碍	睡眠效率	日间功能障碍	睡眠药物使用	PSQI总分
睡眠障碍组	62	1.68±0.35	1.58±0.32	1.97±0.42	1.22±0.17	1.87±0.65	1.73±0.45	1.55±0.35	10.02±0.56
非睡眠障碍组	34	0.95±0.14	0.71±0.31	0.98±0.34	0.78±0.23	0.76±0.21	0.46±0.25	0.74±0.18	4.64±0.31
t值		14.450	12.880	11.781	9.785	12.325	17.776	14.967	60.589
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 3 2组心房颤动患者AFEQT评分比较(x±s，分)

组别	例数	症状严重程度	治疗焦虑	日常活动	治疗满意度	AFEQT总分
睡眠障碍组	62	61.86±12.74	56.42±13.75	48.93±15.82	71.38±16.74	54.94±18.83
非睡眠障碍组	34	77.83±12.81	74.84±13.73	65.92±15.85	73.63±16.95	79.98±18.97
t值		-5.863	-6.281	-5.029	-0.627	-6.215
P值		< 0.001	< 0.001	< 0.001	0.532	< 0.001

下载: 导出CSV

表 4 PSQI总分与生活质量的相关性分析

统计值	症状严重程度	日常活动	治疗焦虑	AFEQT总分
r值	-0.524	-0.425	-0.398	-0.492
P值	0.012	0.027	0.037	0.021

下载: 导出CSV

参考文献(15)

[1]	KIRCHHOF P, BENUSSI S, KOTECHA D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J]. Europace, 2016, 18(11): 1609-1678. doi: 10.1093/europace/euw295
[2]	SZYMANSKI F M, FILIPIAK K J, KARPINSKI G, et al. Occurrence of poor sleep quality in atrial fibrillation patients according to the EHRA score[J]. Acta Cardiol, 2014, 69(3): 291-296. doi: 10.1080/AC.69.3.3027832
[3]	汪京嘉, 杜昕, 李玲, 等. 心房颤动患者生活质量及影响因素分析[J]. 心肺血管病杂志, 2014, 33(6): 799-803. doi: 10.3969/j.issn.1007-5062.2014.06.012
[4]	王佳佳, 刘小丽, 徐琴, 等. 心房颤动患者疾病的接受程度和健康生活质量的影响因素[J]. 临床与病理杂志, 2019, 39(10): 2259-2263. doi: 10.3978/j.issn.2095-6959.2019.10.024
[5]	SANDHU R K, SMIGOROWSKY M, LOCKWOOD E, et al. Impact of electrical cardioversion on quality of life for the treatment of atrial fibrillation[J]. Can J Cardiol, 2017, 33(4): 450-455. doi: 10.1016/j.cjca.2016.11.013
[6]	GENUARDI M V, OGILIVE R P, SAAND A, et al. Short sleep time is associated with increased risk of incident atrial fibrillation[J]. Sleep, 2018, 41(1): A323. http://www.researchgate.net/publication/324806358_0869_Short_Sleep_Time_Is_Associated_With_Increased_Risk_Of_Incident_Atrial_Fibrillation
[7]	敖明强, 潘扬, 马文琦, 等. 心脏科住院心房颤动患者焦虑抑郁情绪调查及其对生活质量的影响[J]. 东南大学学报(医学版), 2017, 36(4): 637-640. doi: 10.3969/j.issn.1671-6264.2017.04.029
[8]	朱小芳, 李良海. 持续正压通气联合导管消融术治疗阻塞性睡眠呼吸暂停综合征伴阵发性房颤患者的疗效观察[J]. 内科急危重症杂志, 2014, 20(4): 264-265. https://www.cnki.com.cn/Article/CJFDTOTAL-NKJW201404023.htm
[9]	KAYRAK M, GUL E E, ARIBAS A, et al. Self-reported sleep quality of patients with atrial fibrillation and the effects of cardioversion on sleep quality[J]. Pacing Clin Electrophysiol, 2013, 36(7): 823-829. doi: 10.1111/pace.12115
[10]	王思洋, 陈丽霞, 刘淇丰, 等. 心房颤动合并焦虑抑郁的研究进展[J]. 国际精神病学杂志, 2018, 45(5): 800-802. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ201805011.htm
[11]	崔京京. 冠心病患者睡眠质量对疾病康复的影响[J]. 世界睡眠医学杂志, 2020, 7(3): 393-394. doi: 10.3969/j.issn.2095-7130.2020.03.010
[12]	KANG K, KIM J, HA H, et al. Effect of age on the association between subjective sleep quality and metabolic syndrome[J]. Sleep, 2017, 40: A394. http://www.onacademic.com/detail/journal_1000040050824610_b340.html
[13]	王雪莹. 心房颤动患者睡眠质量与生活质量的研究[D]. 石家庄: 河北医科大学, 2019.
[14]	杨萍, 杨洋, 于新颖, 等. 肿瘤化疗病人睡眠质量与生活质量相关性研究[J]. 护士进修杂志, 2012, 27(26): 530-532. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201206024.htm
[15]	FICHTNER S, DEISENHOFER I, KINDSMULLER S, et al. Prospective assessment of short- and long-term quality of life after ablation for atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2012, 23(2): 121-127. doi: 10.1111/j.1540-8167.2011.02165.x