肾移植受者衰弱与睡眠质量相关性研究

彭复聪; 王晗; 胡树菁; 李鑫; 郭雪洁; 刘红霞

doi:10.16766/j.cnki.issn.1674-4152.002160

肾移植受者衰弱与睡眠质量相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002160

1.
北京中医药大学护理学院，北京 102488
2.
首都医科大学附属北京朝阳医院泌尿外科，北京 100020

基金项目:

国家自然科学基金面上项目 81572235

详细信息

通讯作者:
刘红霞，E-mail: hongxia_t@163.com

中图分类号: R692 R442.9
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- 文章访问数: 134
- HTML全文浏览量: 59
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2021-02-07
- 网络出版日期: 2022-02-15

Association between frailty and sleep quality in kidney transplant recipients

1.
School of Nursing, Beijing University of Chinese Medicine, Beijing 102488, China

摘要

摘要: 目的探究肾移植受者衰弱与睡眠质量的相关性，为临床预防和干预肾移植受者衰弱提供借鉴。方法纳入2019年6—10月北京市首都医科大学附属北京朝阳医院就诊的200例肾移植受者进行问卷调查，睡眠质量采用匹兹堡睡眠质量量表(PSQI)测量，衰弱情况使用Tilburg衰弱指数量表测量。采用非参数检验比较衰弱与非衰弱肾移植受者的睡眠特点，运用spearman相关分析的方法分析肾移植受者睡眠质量与衰弱的相关关系。结果肾移植受者衰弱发生率为41%，衰弱总得分中位数为3(2, 6)分，以躯体衰弱得分最高。20%的肾移植受者睡眠质量较差，最常见的睡眠问题为日间功能障碍、入睡时间延长以及主观睡眠质量差，分别占总人数的39.50%、35.50%和22.50%。与衰弱肾移植受者相比，非衰弱受者睡眠质量显著较好(Z=-5.745，P＜0.001)。肾移植受者的衰弱评分与睡眠质量评分相关，相关系数r=0.452(P＜0.001)，躯体衰弱和心理衰弱与多种睡眠问题有关。在PSQI各成分中，日间功能障碍与衰弱程度相关性最高(r=0.491，P＜0.001)。结论肾移植受者衰弱发生率较高，存在多种睡眠问题，大部分受者睡眠时间充足，衰弱发生可能与夜间睡眠质量差有关，睡眠质量越差的受者其衰弱程度可能越重，提示应关注肾移植受者夜间睡眠质量，及时识别睡眠障碍，对出现作息时间紊乱、夜间觉醒频繁、睡眠呼吸障碍等问题的受者，采取适当的干预措施帮助受者提高睡眠质量。
- 肾移植受者 /
- 衰弱 /
- 睡眠质量
Abstract: Objective To explore the association between frailty and sleep quality in order to provide evidence for the prevention and treatment of frailty in kidney transplant recipients. Methods A questionnaire survey was conducted among 200 renal transplant recipients. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and frailty was measured using the Tilburg frailty indicator. Non-parametric tests were used for comparing the differences of sleep quality between frail and non-frail recipients. Spearman correlations were used to analyse the relationship between sleep quality and frailty in kidney transplant recipients. Results The rate of frailty was 41%, with medianscores of 3 (2, 6). The highest score was recorded in the area of physical frailty. Twenty percent of recipients had poor sleep quality, with common sleep problems such as daytime dysfunction (39.50%), sleep latency (35.50%) and subjective sleep quality (22.50%). The results of non-parametric tests suggested that the sleep quality was significantly better in non-frail renal transplant recipients than in frail recipients (Z=-5.745, P < 0.001). The PSQI score of kidney transplant recipients was positively correlated with the TFI score, with a correlation coefficient of r=0.452 (P < 0.001). Physical and psychological frailty were related to several sleep problems. Amongst the components of the PSQI, daytime dysfunction and frailty had the strongest correlation (r=0.491, P < 0.001). Conclusion The incidence of frailty in kidney transplant recipients is high, and some of them face multiple sleep problems. Poor night-time sleep quality rather than inadequate sleep duration may be related to frailty. Recipients with poor sleep quality may experience frailty, suggesting that nurses should pay more attention to identifying sleep disorders, especially sleep irregularity, frequent nocturnal awakenings and sleep breathing disorders, so as to provide effective interventions and improve sleep quality in kidney transplant recipients.
- Kidney transplant recipients /
- Frailty /
- Sleep quality

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表 1 200例肾移植受者一般人口学资料和疾病相关资料

项目	类别	例数	百分比(%)
性别	男性	131	65.50
	女性	69	34.50
工作状态	在职	101	50.05
	不在职	99	49.95
BMI	＜18.50	18	9.00
	18.50~23.99	104	50.20
	24.00~27.99	57	28.50
	＞28.00	21	10.50
文化程度	初中及以下	35	17.50
	高中或中专	64	32.00
	大专或本科	88	44.00
	研究生及以上	13	6.50
家庭经济收入(元/月)	≤3 000	25	12.50
	3 000~6 000	49	24.50
	6 000~10 000	58	29.00
	≥10 000	68	34.00
经济负担	无	37	18.50
	轻	62	31.00
	中	60	30.00
	重	41	20.50
有无运动习惯	有	164	82.00
	无	36	18.00
器官来源	尸体捐肾	170	85.00
	活体捐肾	30	15.00

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表 2 200例肾移植受者Tilburg衰弱指数量表得分情况

项目	分值[M(P₂₅，P₇₅)]	得分范围(分)
躯体衰弱	2(1, 3)	0~8
心理衰弱	1(0, 3)	0~4
社会衰弱	1(0, 1)	0~3
衰弱总分	3(2, 6)	0~15

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表 3 200例肾移植受者PSQI量表得分情况

项目	分值 [M(P₂₅，P₇₅)]	得分＞1
项目	分值 [M(P₂₅，P₇₅)]	例数	百分比(%)
睡眠质量	1(0, 1)	45	22.50
入睡时间	1(0, 2)	71	35.50
睡眠时间	0(0, 1)	17	8.50
睡眠效率	0(0, 0)	1	0.50
睡眠障碍	1(1, 1)	21	10.50
催眠药物	1(1, 1)	4	2.00
日间功能障碍	1(1, 2)	79	39.50
PSQI总分	5(3, 7)

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表 4 衰弱与非衰弱肾移植受者PSQI得分比较[M(P₂₅, P₇₅)，分]

组别	睡眠质量	入睡时间	睡眠持续时间	睡眠效率	睡眠障碍	催眠药物	日间功能障碍	睡眠总分
衰弱受者	1(1, 2)	1(0, 2)	0(0, 1)	0(0, 0)	1(1, 1)	0(0, 0)	2(1, 3)	6(4, 9)
非衰弱受者	1(1, 1)	1(0, 2)	0(0, 1)	0(0, 0)	1(1, 1)	0(0, 0)	1(0, 1)	4(2, 6)
Z值	-4.291	-2.314	-1.245	-2.146	-4.219	-0.866	-6.862	-5.745
P值	＜0.001	0.021	0.213	0.032	＜0.001	0.386	＜0.001	＜0.001

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表 5 肾移植受者衰弱状况各维度与睡眠质量各成分的相关分析(r值)

项目	躯体衰弱	心理衰弱	社会衰弱	TFI总分
主观睡眠质量	0.272^a	0.306^a	0.075	0.329^a
入睡时间	0.135	0.244^a	0.059	0.213^a
睡眠持续时间	0.157^b	0.032	0.033	0.115
睡眠效率	0.127	0.120	0.044	0.155^b
睡眠障碍	0.255^a	0.197^a	-0.070	0.240^a
催眠药物	0.132	0.071	-0.046	0.118
日间功能障碍	0.380^a	0.461^a	0.118	0.491^a
PSQI总分	0.381^a	0.410^a	0.101	0.452^a
注：^aP＜0.001；^bP＜0.05。

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