上海市浦东新区社区轻中度慢性阻塞性肺病患者睡眠质量与生命质量的关联研究

 目的 研究上海市浦东新区社区轻中度慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）患者睡眠质量与生命质量之间的关联。方法 本研究为横断面研究，通过随机整群抽样选取6个社区中符合条件的轻中度COPD患者，开展问卷调查，收集相关信息。采用中文版匹兹堡睡眠指数量表（PSQI）评价睡眠质量，以PSQI>7者视为睡眠质量较差，生命质量评估采用欧洲五维三水平量表（EQ-5D-3L）进行。结果 最终纳入273位轻中度COPD患者，其中轻度COPD患者占96.7%，60岁以上者占79.1%，27.5%的患者过去一年间发生过急性加重。29.3%的患者睡眠质量较差，所有患者的EQ-5D-3L效应值平均得分为0.938±0.094，疼痛或不适最常见。多因素回归分析结果表明，调整混杂因素后，与睡眠质量较好的患者相比，睡眠质量较差的患者生命质量更易处于较低水平（OR_ad=1.80，95% CI：1.03~3.14），这一关联在轻度患者中仍然存在，调整后OR为1.90（95% CI：1.07~3.36），日常睡眠障碍可能是影响生命质量的主要睡眠问题（OR_ad=1.26，95% CI：1.02~1.56）。结论 社区轻中度COPD患者中睡眠质量较差者的生命质量处于较低水平，应在诊疗中关注患者睡眠质量以提升生命质量。

Association between sleep quality and quality of life in community-based mild and moderate chronic obstructive pulmonary disease patients in Pudong New Area of Shanghai

Objective To investigate the association between sleep quality and quality of life in patients,with mild and moderate chronic obstructive pulmonary disease (COPD) in Pudong New Area of Shanghai. Methods This was a cross-sectional study involving eligible mild and moderate COPD patients from 6 communities randomly selected in Pudong New Area of Shanghai.Demographic characteristics and clinical information were collected by using a structured questionnaire. Sleep quality was assessed by the Chinese version of Pittsburgh Sleep Quality Index (PSQI),and PSQI>7 was used as cut-off value to clarify the sleep quality.EQ-5D-3L was used to evaluate life quality of patients based on Chinese time trade-off values. Results Altogether 273 mild/moderate COPD patients were included,of 96.7% were mild COPD patients.Most patients (79.1%) were over 60 years old.27.5% patients had exacerbation in past year.29.3% patients reported poor sleep quality.The average scores of EQ-5D-3L were 0.938±0.094.After adjustment of potential confounders,multiple Logistic regression analysis revealed that patients with poor sleep quality was more likely to have poor quality of life (OR_ad=1.80,95%CI:1.03-3.14).Among patients with mild COPD,this association remained (OR_ad=1.90,95%CI:1.07-3.36).Daily sleep disturbance was associated with tthe quality of life in patients with mild COPD(OR_ad=1.26,95%CI:1.02-1.56). Conclusion The quality of life in community-based mild/moderate COPD patients with poor sleep quality experienced much lower quality of life,which need more attention for sleep quality in clinical practices in order to improve the quality of life.