摘要
目的探讨睡眠与冠脉狭窄严重程度的相关性,进一步指导冠心病的防控。方法以2019年2月至6月在本院心内科住院接受冠状动脉造影检查的患者为研究对象,最终收集患者302例,其中男183例,女119例。按照冠状动脉粥样硬化狭窄程度进行分组(无粥样硬化组,狭窄程度<50%组,狭窄程度50%~70%组,狭窄程度>70%组),统计各组患者一般资料、共患病和匹兹堡睡眠质量指数(PSQI)评分,分析冠状动脉粥样硬化狭窄程度加重的危险因素。结果各组年龄、性别以及患糖尿病比例的差异有统计学意义(P<0.05)。各组患高血压、高脂血症的比例差异无统计学意义(P>0.05)。通过Spearman等级相关分析,发现PSQI评分等级与粥样硬化程度呈正相关(P<0.01)。在多因素回归模型中,睡眠质量差(OR=1.75,95%CI:1.14~2.69,P<0.05)、睡眠时间短(OR=1.64,95%CI:1.05~2.55,P<0.05)、日间功能障碍次数多(OR=1.45,95%CI:1.11~1.88,P<0.01)与冠脉狭窄程度增加有关。PSQI总分高(OR=1.13,95%CI:1.06~1.20,P<0.01)、PSQI评价等级低(很差vs很好:OR=13.85,95%CI:1.56~122.82,P<0.05)同样与冠脉狭窄程度增加有关。结论睡眠质量差、睡眠时间短、日间功能障碍次数多是冠脉狭窄程度加重的独立危险因素。高匹兹堡睡眠质量指数与冠脉狭窄程度的加重显著相关。
Objective To explore the correlation between sleep and the severity of coronary artery stenosis,and to further guide the prevention and control of coronary heart disease.Methods A total of 302 patients,including 183 males and 119 females,were enrolled in the department of cardiology of Changhai hospital from February to June 2019.The patients were divided into three groups according to the degree of stenosis(atherosclerotic group,atherosclerotic group with degree of stenosis<50%,atherosclerotic group with degree of stenosis 50%-70%,and atherosclerotic group with degree of stenosis>70%).General information,comorbidities and Pittsburgh sleep quality index(PSQI)of patients in each group were analyzed to compare the differences and analyze the risk factors of aggravated coronary artery stenosis.Results There were statistically significant differences in age,gender and diabetes among all groups(P<0.05).There was no statistically significant difference in the incidence of hypertension and hyperlipidemia in each group(P>0.05).Spearman correlation analysis showed that PSQI score was positively correlated with the degree of atherosclerosis(P<0.01).In the multivariate regression model,poorer sleep quality(OR=1.75,95%CI:1.14-2.69,P<0.05),shorter sleep time(OR=1.64,95%CI:1.05-2.55,P<0.05)and more diurnal dysfunction(OR=1.45,95%CI:1.11-1.88,P<0.01)were correlated with increased coronary artery stenosis.Higher PSQI total score(OR=1.13,95%CI:1.06-1.20,P<0.01)and lower PSQI evaluation grade(very bad vs very good:13.85,95%CI:1.56-122.82,P<0.05)were also related to the increase of coronary artery stenosis.Conclusions Poorer sleep quality,shorter sleep time and more diurnal dysfunction were independent risk factors for the aggravation of coronary artery stenosis.Higher Pittsburgh sleep quality index was significantly associated with the severity of coronary artery stenosis.
作者
李媛媛
张亮
徐荣良
张必利
Li Yuanyuan;Zhang Liang;Xu Rongliang;Zhang Bill(Department of Cardiology,Changhai Hospital Affiliated to Naval Military Medical University,Shanghai 200433,China)
出处
《中国医师杂志》
CAS
2019年第12期1798-1802,共5页
Journal of Chinese Physician
