高原驻防部队官兵睡眠情况调查及其与慢性高原病的相关性分析

发布时间：2018-06-16 11:14

本文选题：睡眠 + 慢性高原病　；参考：《解放军医学杂志》2017年06期

【摘要】：目的了解常驻高原部队官兵的睡眠质量情况,探讨其与慢性高原病之间的关系。方法采用分层随机抽样的方法,从某军区高原驻防部队中抽取956名连续驻守高原6个月以上的男性军人作为高原组,同时抽取该军区在平原地区驻防的587名未进驻过高原的男性军人作为对照组。采用匹兹堡睡眠质量指数量表(PSQI)搜集研究对象的睡眠情况,采用慢性高原病(CMS)症状问卷并结合生理学检查指标确定是否存在CMS以及CMS的程度。比较高原组整体及其两个亚组(健康亚组和CMS亚组)与对照组的各项生理指标和PSQI量表评分的差异。分析高原组PSQI和CMS评分与其生理指标的相关性,及其PSQI睡眠质量各项评分与CMS评分的相关性,分析高原组中3个CMS亚组(健康、轻度、中重度)间PSQI各项分值和生理指标的差异。结果高原组的收缩压、心率和血红蛋白浓度均明显高于对照组(P0.05),血氧饱和度明显低于对照组(P0.05);高原组PSQI各指标分值均明显高于对照组(P0.05)。在高原组中,健康亚组和CMS亚组的收缩压、心率、血氧饱和度和血红蛋白浓度均明显高于对照组(P0.05),且CMS亚组的舒张压明显高于对照组(P0.05);除催眠药物应用这一指标外,高原组中健康亚组和CMS亚组的PSQI各指标均明显高于对照组(P0.05)。在高原组中,睡眠时间分值与收缩压呈明显负相关(P0.05),睡眠效率分值与心率呈明显负相关(P0.05),睡眠时间分值与血氧饱和度呈明显正相关(P0.05);CMS评分与收缩压、舒张压、心率、血红蛋白浓度呈明显正相关(P0.05),与血氧饱和度呈明显负相关(P0.05);除催眠药物应用这一指标外,PSQI各项评分与CMS评分均呈明显正相关(P0.05)。在高原组的3个亚组中,轻度和中重度CMS亚组的血氧饱和度明显低于健康亚组(P0.05),而血红蛋白浓度明显高于健康亚组(P0.05);轻度、中重度CMS亚组睡眠障碍、PSQI总分分值明显高于健康亚组(P0.05),而中重度CMS亚组的睡眠质量、睡眠时间、睡眠效率和日间功能紊乱分值明显高于健康亚组和轻度CMS亚组(P0.05)。结论常驻高原部队官兵的睡眠质量与对照组比较明显降低,不仅与高原生活工作经历有关,也与CMS相关。随着CMS症状的加重,睡眠质量不断下降,尤以睡眠效率、睡眠障碍、PSQI总分分值的下降为著。在改善常驻高原部队官兵睡眠质量的同时须加强对CMS的防治。
[Abstract]:Objective to investigate the sleep quality and the relationship between sleep quality and chronic altitude disease. Methods 956 male soldiers who had been stationed on the plateau for more than 6 months were selected from the plateau garrison of a military region by stratified random sampling as the plateau group. At the same time, 587 male soldiers who were not stationed in the plateau were selected as control group. Pittsburgh Sleep quality Index (PSQI) was used to collect the sleep condition of the subjects, and the symptom questionnaire of chronic altitude sickness (CMSS) was used to determine whether there was CMS and the extent of CMS. The differences of physiological indexes and PSQI scores between the two subgroups (health subgroup and CMS subgroup) and the control group were compared. To analyze the correlation between PSQI and CMS scores and their physiological indexes, and the correlation between PSQI sleep quality scores and CMS scores, 3 CMS subgroups (healthy, mild) in plateau group were analyzed. Differences of PSQI scores and physiological indexes between moderate and severe). Results the systolic blood pressure, heart rate and hemoglobin concentration in the high altitude group were significantly higher than those in the control group (P 0.05), the blood oxygen saturation was significantly lower than that in the control group (P 0.05), and the scores of PSQI indexes in the high altitude group were significantly higher than those in the control group (P 0.05). In high altitude group, systolic blood pressure, heart rate, blood oxygen saturation and hemoglobin concentration in healthy subgroup and CMS subgroup were significantly higher than those in control group (P 0.05), and diastolic blood pressure in CMS subgroup was significantly higher than that in control group (P 0.05). The PSQI of healthy subgroup and CMS subgroup in high altitude group were significantly higher than that in control group (P 0.05). In high altitude group, sleep time score was negatively correlated with systolic blood pressure (P 0.05), sleep efficiency score was negatively correlated with heart rate (P 0.05), sleep time score was positively correlated with blood oxygen saturation (P 0.05), CMS score was positively correlated with systolic blood pressure, diastolic blood pressure, heart rate. There was a significant positive correlation between hemoglobin concentration and blood oxygen saturation (P0.05A) and a significant positive correlation between PSQI scores and CMS scores except hypnotic drug use. In the three subgroups of the high altitude group, the blood oxygen saturation of mild and moderate severe CMS subgroups was significantly lower than that of the healthy subgroup P0.05, but the hemoglobin concentration was significantly higher than that of the healthy subgroup P0.05. The total score of PSQI in moderate and severe CMS subgroup was significantly higher than that in healthy subgroup (P0.05), while the sleep quality, sleep time, sleep efficiency and daytime dysfunction score in moderate and severe CMS subgroup were significantly higher than those in healthy subgroup and mild CMS subgroup (P0.05). Conclusion the sleep quality of the officers and soldiers living at high altitude was significantly lower than that of the control group, which was not only related to the life and work experience at high altitude, but also to CMS. With the exacerbation of CMS symptoms, sleep quality decreased, especially the sleep efficiency and the total score of PSQI. In order to improve the sleep quality of officers and soldiers in plateau troops, the prevention and treatment of CMS should be strengthened.
【作者单位】：第三军医大学卫勤训练基地卫生勤务学教研室;第三军医大学高原医学系高原环境医学教育部重点实验室全军高原生理与高原病研究重点实验室高原特需药品与卫生装备研究室;
【基金】：国家基础科学人才培养基金(J1310001) 全军“十二五”重大课题(AWS14C007) 全军“十二五”重点课题(EWS11J042)~~
【分类号】：R82

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