昆明市棕树营社区高血压患者睡眠状况调查

发布时间：2018-05-11 14:23

本文选题：社区高血压 + 睡眠障碍　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]通过对昆明市棕树营社区高血压患者的主观睡眠状况调查,探讨性别、年龄、职业、文化程度、退休情况、既往躯体疾病史、经济收入及血压控制水平对高血压患者睡眠障碍患病率的影响,为高血压的社区管理及防治提供参考。[方法]2017年1月至2017年4月调查在棕树营社区卫生服务中心建立健康档案的高血压患者共450人,33人因信息不全面剔除,共收入417人,通过社区门诊对病人进行随访调查,内容包括性别、年龄、职业、文化程度、退休情况、既往躯体疾病史、经济收入、血压控制水平、主观睡眠质量及焦虑抑郁情况。主观睡眠质量的评估目前公认用于评估受试者近1个月主观睡眠质量的是匹兹堡睡眠质量指数(PSQI)量表,其共包括19个自评条目和5个他评条目,其中第19个自评条目和5个他评条目不参与计分,总分0～21分,得分越高,表示睡眠质量越差。0～6分为无睡眠障碍,7～11分为轻度睡眠障碍,12～16分为中度睡眠障碍,17～21分为重度睡眠障碍。焦虑及抑郁状况评估使用医院焦虑抑郁量表(HADS)评估,HADS在综合医院门诊和健康人群体检的中均有较高的信度及效度。HADS由14个条目组成,其中7个条目评定为抑郁,7个条目评定为焦虑。共有6条反向提问条目,5条在抑郁分量表,1条在焦虑分量表。抑郁/焦虑总分为0～21分:0～7分无抑郁/焦虑,8～10分可能或临界抑郁/焦虑,11～21分明显抑郁/焦虑。根据资料统计分析高血压患者的睡眠障碍患病率与性别、年.龄、职业、文化程度、退休情况、既往躯体疾病史、经济收入及血压控制水平是否具有相关性。[结果]1、本研究显示417例高血压患者中合并睡眠障碍者共189例,患病率为45.3%。2、女性高血压患者睡眠障碍患病率(51.9%)高于男性高血压患者(36.5%),高血压患者不同性别之间睡眠障碍患病率差异有统计学意义(P0.05)。女性轻、中、重度睡眠障碍的患病率(分别为25.1%、22.6%、4.2%)均高于男性(分别为24.2%、10.1%、2.2%),以中度睡眠障碍的患病率差异最为明显。3、65岁的高血压患者与≥65岁的高血压患者之间,其睡眠障碍的患病率分别为40.2%、47.7%,两者比较差异无统计学意义(P0.05)。4、脑力劳动与体力劳动的高血压患者(以其未退休前的工作情况进行区分,包括已退休的高血压患者)其睡眠障碍患病率分别为46.1%,44.3%,两者比较差异无统计学意义(P0.05)。5、退休与未退休高血压患者比较,两者之间差异统计学意义(P0.05)。已退休的高血压患者(包括既往为农民、小商贩等无工作单位但现已不再从事任何职业的人员)睡眠障碍的患病率(46.1%)明显高于未退休的高血压患者(35.5%)。6、不同文化程度高血压患者之间其睡眠障碍的患病率分别为46.2%(小学及以下),48.7%(中学),37.6%(大学及以上),差异有统计学意义(P0.05)。7、有躯体疾病史的高血压患者其睡眠障碍的患病率(58.1%)明显高于无躯体疾病史的高血压患者(36.3%),差异有统计学意义(P0.001),8、高血压患者家庭平均月收入3500元及以下者与3500元以上者睡眠障碍患病率分别为48.0%、39.0%,两者比较差异无统计学意义(P0.05)。9、平均血压SBP140mmHg和DBP90mmHg的高血压患者及SBP≥140mmHg和(或)DBP≥90mmHg的高血压者睡眠障碍患病率分别为51.1%、42.4%,两者比较差异无统计学意义(P0.05)。[结论]1、本研究女性高血压患者睡眠障碍的患病率高于男性高血压患者,尤其以中度睡眠障碍的患病率明显高于男性,当女性高血压患者血压控制出现波动调整降压药物效果欠佳时,更应注意其睡眠状况。2、退休的高血压患者(包括既往为农民、小商贩等无工作单位但现已不再从事任何职业的人员)睡眠障碍患病率明显高于未退休的高血压患者(包括农民、小商贩等只要尚在工作均归于未退休人员)。已退休的高血压患者的血压控制更应结合其睡眠情况进行综合分析。3、不同文化程度的高血压患者之间其睡眠障碍的患病率存在差异,中学学历者的睡眠障碍患病率最高,小学及以下者次之,大学及以上最低。本研究结果提示高血压患者睡眠障碍患病率与文化程度有关,中学学历特别是初中学历的高血压患者更应重视其睡眠质量。4、既往有躯体疾病史的高血压患者其睡眠障碍患病率明显高于无躯体疾病史的高血压患者。5、本研究高血压患者睡眠障碍的患病率与年龄、职业、血压控制水平、经济收入无相关性,需扩大样本量进一步研究。
[Abstract]:[Objective] to explore the influence of sex, age, occupation, education, retirement, past physical disease history, economic income and blood pressure control level on the prevalence of sleep disorders in hypertensive patients by investigating the subjective sleep status of hypertensive patients in Kunming brown tree camp community, and to provide reference for the community management and prevention of hypertension. [method]2 From January to April 2017, a total of 450 people were investigated for the establishment of health records in the palm tree camp community health service center. 33 people were excluded from the information and received 417 people. The patients were followed up through the community outpatient clinic, including gender, age, occupation, degree of literature, retirement, history of past somatic diseases, and economic income. The level of blood pressure control, subjective sleep quality and anxiety and depression. The assessment of subjective sleep quality is currently used to assess the subjective sleep quality of the subjects for the last 1 months. The Pittsburgh sleep quality index (PSQI) scale, which includes 19 self-evaluation items and 5 items of his evaluation, nineteenth self-evaluation items and 5 entries without participation. The score of the total score was 0~21 points, the higher the score, the worse the sleep quality was.0 to 6, 7~11 was mild sleep disorder, 12~16 was moderate sleep disorder, 17~21 was severe sleep disorder. The evaluation of anxiety and depression was assessed using the hospital anxiety and Depression Scale (HADS), and HADS was examined in the outpatient and healthy people of the general hospital. The high reliability and validity of.HADS was composed of 14 items, of which 7 items were rated as depression and 7 items were rated as anxiety. There were 6 reverse questions, 5 in the depression scale, 1 in the anxiety scale. The total score of depression / anxiety was 0~21, 0~7 had no depression / worry, 8~10 points or critical depression / anxiety, 11~21 points. Significant depression / anxiety. According to data analysis, whether the incidence of sleep disorders in hypertensive patients was correlated with sex, age, age, occupation, education, retirement, history of past somatic disease, economic income and blood pressure control. [results]1, this study showed that 189 patients with 417 patients with high blood pressure were associated with sleep disorders. The rate of 45.3%.2, the incidence of sleep disorders in women with hypertension (51.9%) was higher than that of men with hypertension (36.5%), and there was a significant difference in the incidence of sleep disorders among the patients with hypertension (P0.05). The prevalence of mild, moderate, and severe sleep disorders in women (25.1%, 22.6%, 4.2%) were higher than those of men (24.2%, 10.1%, 2.2%, respectively). The difference in the prevalence of moderate sleep disorders between.3,65 years old and hypertension patients aged 65 years was 40.2% and 47.7%, respectively, and there was no significant difference between the two (P0.05).4, and the high blood pressure patients with mental labor and physical labor were distinguished by their pre retirement work. The prevalence of sleep disorders, including retired hypertension, was 46.1%, 44.3%, and there was no significant difference between the two (P0.05).5. The difference between the retired and the non retired hypertension patients was statistically significant (P0.05). The prevalence of sleep disorders (46.1%) was significantly higher than that of non retired hypertension (35.5%).6, and the prevalence of sleep disorders among hypertensive patients with different educational levels was 46.2% (primary and below), 48.7% (middle school), 37.6% (P0.05), and the difference was statistically significant (P0.05).7, with a history of somatic disease The incidence of sleep disorders in hypertensive patients (58.1%) was significantly higher than that of hypertension patients without the history of somatic disease (36.3%), the difference was statistically significant (P0.001), 8, the average monthly income of 3500 yuan and less than 3500 yuan in patients with hypertension was 48% and 39%, respectively, and there was no significant difference between the two (P0.05). .9, the incidence of sleep disorders in hypertensive patients with average blood pressure of SBP140mmHg and DBP90mmHg and those with SBP > 140mmHg and (or) DBP > 90mmHg were 51.1%, 42.4%, respectively, and there was no significant difference (P0.05). [conclusion]1, the prevalence of sleep disorders in women with hypertension was higher than that of male hypertensive patients, especially moderate to moderate hypertension. The prevalence of sleep disorders is significantly higher than that in men. When women with hypertension have poor blood pressure control, they should pay more attention to their sleep status,.2. Retired hypertensive patients (including those who have no work units such as farmers, small vendors but no longer engaged in any profession) have a significant rate of sleep disorder. High blood pressure in patients with high blood pressure (including farmers, peddlers, etc. as long as they are still in work). The blood pressure control of retired hypertensive patients should be combined with their sleep conditions to make a comprehensive analysis of.3. There is a difference in the prevalence of sleep barriers between people with different educational levels and the sleep of high school students. The results of this study suggest that the prevalence of sleep disorders in hypertensive patients is associated with the degree of sleep disorder. High school education, especially those with high school education, should pay more attention to their sleep quality.4, and the prevalence of sleep disorders in patients with a history of somatic disease is clear. The incidence of sleep disorders in hypertensive patients with.5 was higher than in the history of somatic disease. The incidence of sleep disorders in hypertensive patients was not related to age, occupation, blood pressure control level, and economic income. Further study was needed to expand the sample size.

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

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