老年高血压患者睡眠质量与血压控制水平的相关性研究

发布时间：2018-02-26 19:04

本文关键词： 高血压患者睡眠质量老年人城乡居民　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的在安徽省合肥市和马鞍山市郑浦港新区姥桥镇随机抽取60岁及以上高血压患者进行睡眠质量调查和血压测量,分析老年高血压患者血压水平和睡眠质量,探讨睡眠质量与高血压之间相关性及影响老年高血压患者睡眠质量的因素。方法2015年7月和2016年7月,在合肥市选取荷叶地街道社区、七里塘街道社区和西园街道社区等3个社区和马鞍山市郑浦港新区姥桥镇选取姥长村、红光村和官塘村等3个行政村为调查现场,在社区卫生服务中心和村卫生室获取高血压患者名单,以60岁以上高血压患者为调查对象,通过电话预约入户询问调查和血压测量收集资料,实际共调查和测量1021例高血压患者,获得有效问卷856份,有效率为83.8%。本次调查采用自行设计的调查对象基本情况问卷和匹兹堡睡眠质量指数量表,内容包括调查对象的基本情况如年龄、性别、文化程度、医保形式等问题;老年高血压患者睡眠质量。调查员经过培训后以一对一的方式对调查对象进行问卷调查,并按标准进行血压测量。按照《中国高血压防治指南2010》将血压分为正常血压、正常高值血压、1级高血压、2级高血压和3级高血压5个等级。问卷核查后利用Epidata3.1和SPSS16.0进行数据录入和数据分析。结果(1)城市老年高血压患者平均血压水平为139.98/80.91mm Hg,农村为141.25/80.64mm Hg,城乡差异无统计学意义(P0.05);城市老年高血压患者血压分级水平以正常高值和1级高血压水平为主,分别占38.9%、40.8%;农村老年高血压患者以正常高值和1级高血压水平为主,分别占32.9%和43.5%,差异无统计意义(χ2=5.693,P=0.223);城市老年高血压患者ISH比例为31.8%,农村39.1%,差异有统计学意义(χ2=4.788,P=0.029)。(2)城市老年高血压患者PSQI总体评分为7.31±3.96分,农村PSQI总体评分为9.02±3.94分。城市与农村老年高血压患者在睡眠时间、睡眠障碍、入睡时间、睡眠效率、主观睡眠质量及PSQI总体评分等差异有统计学意义(P0.05),农村老年高血压患者在睡眠时间、睡眠障碍、睡眠效率、主观睡眠质量及PSQI总体评分方面得分高于城市,在入睡时间方面得分低于城市。(3)不同血压分级水平老年高血压患者在日间功能障碍方面差异有统计学意义(P0.05)。ISH患者与非ISH患者睡眠效率存在差异(P0.05),ISH患者睡眠质量比非ISH患者差。老年高血压患者PSQI总体评分和7个维度与SBP、DBP均无明显相关性;但脉压差与睡眠效率得分呈正相关。(4)单因素分析发现性别、文化层次、职业、医保形式是老年高血压患者睡眠质量的影响因素;Logistic回归分析发现女性、新型农村合作医疗保险患者、患高血压≥5年、不服用降压药是睡眠质量的危险因素。结论(1)城市与农村老年高血压患者平均血压水平略低,主要集中于正常高值水平和1级高血压水平,ISH患者比例较高。且睡眠障碍发生率较高,农村高于城市。(2)老年高血压患者PSQI总体评分和7个维度得分与SBP、DBP均无明显相关性。(3)老年高血压患者日间功能障碍随着血压水平升高而加重,SBP波动和脉压差对老年高血压患者睡眠效率有影响。(4)女性、文化层次低、从事体力劳动者、新型农村合作医疗保险患者、患高血压≥5年的老年人群、不服用降压药者睡眠质量差。
[Abstract]:In Anhui city of Hefei province and Ma'anshan City Zheng Pugang District Mu Qiao Zhen were randomly selected from 60 years old and above in patients with hypertension and to investigate the sleep quality and blood pressure measurement, blood pressure and sleep quality of elderly patients with hypertension, to explore the factors of hypertension and correlation between sleep quality and sleep quality of patients with elderly hypertension. Methods in July 2015 and July 2016, from lotus leaf the street community in Hefei City, Seven Mile pond street community and Community Park Street 3 communities and Ma'anshan city Pugang District Mu Qiao Zhen Long Cun Mu from 3 administrative villages, village and village red Kwun Tong as the survey sites, access list of hypertensive patients in the community health service centers and village clinics, to 60 years old more patients with hypertension as the research object, through the telephone booking investigation and blood pressure measurement data collection, investigation and measurement of the actual total 1021 cases The blood pressure of patients, 856 valid questionnaires were obtained. The effective rate was 83.8%. the survey using self-designed survey questionnaire and Pittsburgh sleep quality index scale, including the survey of the basic situation such as age, gender, education level, health care and other issues form; sleep quality of elderly patients with hypertension after training investigators. In one way of the survey questionnaire, and blood pressure was measured according to the standard. In accordance with the "guidelines for prevention and treatment of hypertension Chinese 2010> blood pressure divided into normal blood pressure, high normal blood pressure, hypertension of grade 1, grade 2 and grade 3 hypertension hypertension grade 5. After verification of questionnaire data entry and data analysis using Epidata3.1 and SPSS16.0 (1). The city average blood pressure in elderly hypertensive patients was 139.98/80.91mm Hg, 141.25/80.64mm Hg in rural areas, there was no significant difference between urban and rural areas (P0.05); The classification of blood pressure in elderly hypertensive patients with normal level of city high value and grade 1 hypertension level, accounted for 38.9%, 40.8%; rural elderly hypertensive patients with grade 1 hypertension and high normal levels, accounted for 32.9% and 43.5%, the difference was not statistically significant (x 2=5.693, P= 0.223); city ISH ratio of elderly patients with hypertension 31.8%, rural 39.1%, the difference was statistically significant (2=4.788, P=0.029). (2) PSQI city elderly hypertensive patients overall score was 7.31 + 3.96, rural PSQI total score was 9.02 + 3.94. The city and the rural elderly patients with high blood pressure during sleep time, sleep disorders, sleep time, sleep efficiency, statistical the significance of subjective sleep quality and overall PSQI score difference (P0.05), rural elderly hypertensive patients in the sleep time, sleep disorders, sleep efficiency, subjective sleep quality and the overall PSQI score was higher than that in the city. Sleep time scores lower than the city. (3) was statistically significant different blood pressure levels in elderly patients with hypertension level differences in daytime dysfunction (P0.05) in patients with.ISH and non ISH patients with sleep efficiency differences (P0.05), ISH patients with poor quality of sleep in patients with non ISH. The old PSQI patients with hypertension and 7 dimensions and total score of SBP DBP, there were no obvious correlation; but the pulse pressure was positively correlated with sleep efficiency score (4). Univariate analysis showed that gender, cultural level, occupation, medical insurance form is the influencing factors of sleep quality of elderly patients with hypertension; Logistic regression analysis showed that female, the new rural cooperative medical insurance patients suffering from hypertension, aged 5 years, did not take antihypertensive drugs were risk factors of sleep quality. Conclusion (1) city and rural elderly hypertensive patients average blood pressure level is slightly lower, mainly concentrated in the high normal level and grade 1 hypertension level, ISH A higher proportion of patients. And the incidence of sleep disorder is higher in rural areas than in the city. (2) in elderly patients with hypertension PSQI overall score and 7 dimension scores of SBP and DBP, were not significantly correlated. (3) in elderly patients with hypertension and daytime dysfunction increased with blood pressure levels, SBP wave and pulse pressure have influence on the elderly patients with hypertension sleep efficiency. (4) women, low cultural level, manual workers, the new rural cooperative medical insurance patients, elderly people suffering from hypertension is more than 5 years, not taking antihypertensive drugs have poor quality of sleep.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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