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肠易激综合征患者的睡眠特征
作者姓名:Wu JP  Song ZY  Xu Y  Zhang YM  Shen RH
作者单位:1. 杭州市余杭区第五人民医院内科,311100
2. 浙江大学医学院附属第二医院消化内科,杭州,310009
摘    要:目的 分析伴焦虑抑郁和无焦虑抑郁的肠易激综合征(IBS)患者睡眠质量的差别,探讨IBS患者的睡眠特征.方法 采用pittsburgh睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对IBS患者(145例)及健康体检志愿者(59例)进行问卷调查,再根据焦虑或抑郁评分对IBS患者分为无焦虑抑郁亚组和伴焦虑抑郁亚组,进行统计学分析.结果 在SAS、SDS量表中,IBS组的SAS粗分、SDS粗分及SAS粗分阳性率均比健康对照组高(29.43±15.24比26.10±11.55,31.29±13.32比26.51±13.91,12.41%比3.39%),差异均有统计学意义(P值均<0.05),SDS粗分阳性率与健康对照组相比,差异无统计学意义(P>0.05).在PSQI量表中,IBS组及无焦虑抑郁IBS亚组在睡眠质量、睡眠障碍、日间功能障碍等3个因子及PSQI总分比健康对照组高,差异有统计学意义(P<0.05);伴焦虑抑郁的IBS亚组在睡眠质量、入睡时间、睡眠效率、睡眠障碍、睡眠时间、日间功能障碍等6个因子和PSQI总分比健康对照组高,差异有统计学意义(P<0.05);伴焦虑抑郁的IBS亚组在所有7个因子和PSQI总分均比无焦虑抑郁的IBS亚组高,差异有统计学意义(P<0.05).结论 IBS患者存在睡眠异常,主要表现在睡眠质量、睡眠障碍、日间功能障碍3个因子和PSQI总分异常,这些因子的异常独立于患者的情绪障碍,但情绪障碍会加重IBS患者的睡眠异常.

关 键 词:肠易激综合征  睡眠异常  焦虑自评量表  抑郁自评量表  Pittsburgh睡眠质量指数量表

Probe into sleep quality in the patients with irritable bowel syndrome
Wu JP,Song ZY,Xu Y,Zhang YM,Shen RH.Probe into sleep quality in the patients with irritable bowel syndrome[J].Chinese Journal of Internal Medicine,2010,49(7):587-590.
Authors:Wu Jun-ping  Song Zhen-ya  Xu Yi  Zhang Yi-min  Shen Rong-hai
Institution:Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China. wjp86207@163.com
Abstract:Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P < 0.05 ), while the SDS positive incidence had no statistically significant difference(P > 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P < 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P < 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P < 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P < 0.05 ).Statistically significant differences (P <0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.
Keywords:Irritable bowel syndrome  Dyssomnias  Self-rating anxiety scale  Self-rating depression scale  Pittsburgh sleep quality index
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