维持性血液透析患者微炎症状态与睡眠质量相关因素分析

目的：探讨影响尿毒症维持性血液透析患者睡眠质量的相关因素以及睡眠质量下降患者炎症因子水平。方法：选取2011年1月至2013年12月在门诊进行维持性血液透析的119例患者,将匹兹堡睡眠质量指数（Pittsburgh sleep quality index,PSQI）评分作为睡眠质量评分,PSQI〈5分为睡眠质量较好,PSQI≥5分为睡眠质量较差。分析维持性血液透析患者睡眠质量与年龄、透析龄、体重指数、透析充分性等的相关性。各选取20例PSQI〈5分,PSQI≥5分的患者,比较2组患者白细胞介素1（IL-1）、白细胞介素6（IL-6）及肿瘤坏死因子α（TNF-α）的水平。结果：PSQI与年龄、肌酐、甲状旁腺激素、C反应蛋白水平呈正相关（P〈0.05）,与透析充分性呈负相关（P〈0.05）,与血红蛋白水平、体重指数、透析龄不相关。PSQI≥5分患者的IL-1、IL-6、TNF-α水平均高于PSQI〈5分患者（P〈0.05）。结论：维持性血液透析患者睡眠质量与年龄、透析充分性等相关。睡眠质量下降可能导致炎症因子增加。

Correlation between Microinflammation and Sleeping Quality in Maintenance Hemadialysis Patients

Objective： To observe the factors that influencing sleeping quality of maintenance hemodialysis patients,and the microinflammation factors level of low sleeping quality patients. Methods： A total of 119 patients who did hemodialysis from Jan 2011 to Dec 2013 were enrolled. Pittsburgh sleep quality index（ PSQI） was used to evaluate sleep quality,PSQI ＆lt; 5 was as sleep good bad and PSQI≥5 was as sleep quality bad. The relationship between sleeping quality and age,dialysis time,body mass index,dialysis adequacy etc was analyzed. The IL-1,IL-6 and TNF-α level between PSQI ＆lt; 5（ n = 20） and PSQI≥5 group（ n = 20） was compared. Results： PSQI had positive correlation with age,the level of creatinine,parathyroid hormone and C-reactive protein（ P ＆lt;0. 05）,and had negative correlation with dialysis adequacy（ P ＆lt; 0. 05） and had no correlation with hemoglobin level,body mass index and dialysis time. IL-1,IL-6 and TNF-α level were higher in PSQI≥5 group than that in PSQI ＆lt; 5 group（ P ＆lt; 0. 05）. Conclusions： The sleeping quality in maintenance hemodialysis is correlated with age and dialysis adequacy etc. Bad sleeping quality may cause the microinflammation factors increase.