影响2型糖尿病患者睡眠质量的相关因素研究

目的 探讨影响2型糖尿病患者睡眠质量的相关因素.方法 随机选取上海第六人民医院内分泌科就诊的2型糖尿病患者283例,使用匹兹堡睡眠质量指数量表与汉密尔顿抑郁量表对患者的睡眠质量及抑郁状态进行评估.数据资料使用卡方检验、独立样本t检验、U检验、Spearman相关、逐步线性回归分析等进行分析.结果 2型糖尿病患者中,按睡眠质量分为两组,睡眠障碍患者（睡眠质量指数＞7）占32.16％（91例）.两组患者之间的胰岛素使用比例、抑郁状态比例的差异有统计学意义（x2=14.337、70.910,P=0.001）,舒张压的差异有统计学意义（Z=-2.172,P=0.030）,汉密尔顿抑郁量表焦虑躯体化、认识障碍、日夜变化、阻滞、睡眠障碍、绝望感等抑郁因子得分存在统计学差异（Z=-5.961、-4.854、-7.159、-7.159、-10.183、-4.882,均P＜0.05）.睡眠质量指数分别与抑郁评分、是否注射胰岛素这两个变量的相关性存在统计学意义（r =0.682,P＜0.05;r =0.209,P ＜0.05）,抑郁评分、是否注射胰岛素是影响睡眠质量指数的独立相关因素（β=0.430,P ＜0.05；β=1.142,P=0.022）.在注射胰岛素的患者中,注射胰岛素的次数与低血糖事件频率的相关性有统计学意义（r =0.235,P=0.041）,低血糖事件频率与抑郁评分的相关性有统计学意义（r=0.275,P=0.016）.结论 抑郁状态、注射胰岛素会影响2型糖尿病患者的睡眠质量.

Influencing factors of quality of sleep in patients with type 2 diabetes mellitus

Objective To investigate the influencing factors of sleep quality in patients with type 2 diabetes mellitus （T2DM）.Methods Two hundred and eighty-three T2DM patients were enrolled in this investigation interviewed exclusively for Pittsburgh Sleep Quality Index （PSQI） and Hamilton Depression Scale （HAMD）.Chi-square test,independent-samples t test,Mann-Whitney U test,Spearman correlation,stepwise regression analysis were used for data analysis.Results Ninety-one T2DM patients （32.16％）suffered from sleep disorders.Those with or without sleep disorders showed significant differences in insulin use （x2 =14.337,P =0.001）,depression （x2 =70.910,P =0.001）,diastolic blood pressure （Z =-2.172,P =0.030） and HAMD （P ＜ 0.05）.PSQI score was significantly correlated with insulin injection and HAMD score （r values were 0.682 and 0.209,respectively ; both P ＜ 0.05）.HAMD score and insulin injection were significantly independent risk factors of PSQI score （β values were 0.430 and 1.142,respectively; P ＜ 0.05 or P =0.022）.In those subjects who have insulin injection,times of injection was significantly correlated with the frequency of hypoglycemia （r =0.235,P =0.041）,and hypoglycemia was significantly correlated with HAMD score （r =0.275,P =0.016）.Conclusion Depression and insulin injection may affect sleep quality of T2DM patients.