唾液皮质醇水平与睡眠质量关系的研究

发布时间：2018-07-03 09:55

本文选题：成年人 + 睡眠质量　；参考：《浙江大学》2015年硕士论文

【摘要】：背景：随着当今信息时代发展步伐的逐步加快,社会经济迅猛发展,人们生活节奏也随之加快,造成人们工作趋忙、压力增大。上班族们面临不同的健康隐患,人的负性情绪和睡眠障碍也随之而来。良好的睡眠质量有助于提高人们的工作、生活、学习效率和保持较好的社会适应能力。肾上腺皮质分泌的皮质醇是调节人体内分泌系统的重要组分,下丘脑-垂体-肾上腺轴(HPA轴)的昼夜分泌生理节律会影响它的水平波动。类似皮质醇激素水平的昼夜节律变化具有调节神经内分泌、稳定内环境、调节免疫、抗氧化、调节人体正常睡眠周期、使人体适应外界环境变化、协调人体生理反应等多种功能。目的：探讨唾液皮质醇与睡眠质量的关系,分析唾液皮质醇对睡眠障碍的评价诊断价值。方法：采用整群抽样法对杭州市2家大型企业职工进行体检,按纳入和排除标准选取571名成年人为研究对象(年龄20-60周岁),收集年龄、性别、身高、体重等资料,收集唾液样本,用光化学免疫法测定唾液皮质醇水平。采用匹兹堡睡眠质量指数(PSQI)对研究对象进行睡眠质量调查,对研究对象近一个月来主观睡眠质量进行评定。结果：研究对象中有46.8%的人出现睡眠障碍,其中女性研究对象的睡眠质量要比男性研究对象的睡眠质量差(p0.05)。唾液皮质醇水平和PSQI评分呈正相关(spearman相关系数=0.632,p0.01)。男性研究对象工作特征曲线(ROC曲线)分析唾液皮质醇对睡眠障碍的诊断价值,曲线下面积(AUC)为0.873(95%置信区间为：0.839-0.911),最接近ROC曲线左上角的唾液皮质醇水平浓度6.55nmol/L为筛检试验最佳阳性临界点,其对应的灵敏度为78.5%,特异性为84.0%。女性研究对象工作特征曲线分析唾液皮质醇对睡眠障碍的诊断价值,曲线下面积(AUC)为0.885(95%置信区间为：0.841-0.929),最接近ROC曲线左上角的唾液皮质醇水平浓度7.40nmol/L为筛检试验最佳阳性临界点,其对应的灵敏度为68.3%,特异性为87.8%。结论：唾液皮质醇水平与睡眠质量有很强的相关性,睡眠障碍程度的加深伴随着唾液皮质醇水平的升高。唾液皮质醇检测可考虑作为睡眠障碍诊断的一种辅助手段。
[Abstract]:Background: with the rapid development of the information age, the rapid development of social economy, people's rhythm of life is also accelerated, resulting in people tend to work busy, increased pressure. Office workers face different health risks, followed by negative emotions and sleep disorders. Good sleep quality helps to improve people's work, life, learning efficiency and social adaptability. Cortisol secreted by the adrenal cortex is an important component of the endocrine system. The circadian rhythm of the hypothalamus-pituitary-adrenal axis (HPA axis) may affect its level fluctuation. Circadian rhythms similar to cortisol levels regulate neuroendocrine, stabilize the internal environment, regulate immunity, antioxidation, regulate the body's normal sleep cycle, and enable the human body to adapt to changes in the external environment. Coordinate human physiological response and other functions. Objective: to investigate the relationship between salivary cortisol and sleep quality and to analyze the diagnostic value of salivary cortisol in sleep disorder. Methods: a total of 571 adults (20-60 years old) were selected by cluster sampling for physical examination of two large enterprises in Hangzhou. The data of age, sex, height and weight were collected. The salivary cortisol levels were measured by photochemical immunoassay. Pittsburgh Sleep quality Index (PSQI) was used to evaluate the subjective sleep quality of the subjects. Results: 46.8% of the subjects had sleep disorders, and the sleep quality of female subjects was worse than that of male subjects (p0.05). There was a positive correlation between salivary cortisol level and PSQI score (spearman correlation coefficient was 0.632p0.01). The diagnostic value of salivary cortisol in sleep disorders was analyzed by work characteristic curve (ROC curve) in male subjects. The area under the curve (AUC) was 0.873 (95% confidence interval: 0: 0.839-0.911). The salivary cortisol concentration closest to the upper-left corner of the ROC curve was 6.55 nmol / L, which was the best positive critical point for the screening test. The sensitivity was 78.5 and the specificity was 84.0. The diagnostic value of salivary cortisol on sleep disorder was analyzed by working characteristic curve of female subjects. The area under the curve (AUC) was 0.885 (95% confidence interval: 0: 0.841-0.929). The salivary cortisol concentration closest to the upper left corner of the ROC curve was 7.40nmol / L, which was the best positive critical point for the screening test. The sensitivity was 68.3% and the specificity was 87.8%. Conclusion: salivary cortisol level has a strong correlation with sleep quality, and the degree of sleep disorder is associated with the increase of salivary cortisol level. Salivary cortisol detection may be considered as an auxiliary method for the diagnosis of sleep disorders.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R740

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