本文關(guān)鍵詞： 高血壓患者 睡眠質(zhì)量 老年人 城鄉(xiāng)居民　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的在安徽省合肥市和馬鞍山市鄭浦港新區(qū)姥橋鎮(zhèn)隨機(jī)抽取60歲及以上高血壓患者進(jìn)行睡眠質(zhì)量調(diào)查和血壓測(cè)量,分析老年高血壓患者血壓水平和睡眠質(zhì)量,探討睡眠質(zhì)量與高血壓之間相關(guān)性及影響老年高血壓患者睡眠質(zhì)量的因素。方法2015年7月和2016年7月,在合肥市選取荷葉地街道社區(qū)、七里塘街道社區(qū)和西園街道社區(qū)等3個(gè)社區(qū)和馬鞍山市鄭浦港新區(qū)姥橋鎮(zhèn)選取姥長(zhǎng)村、紅光村和官塘村等3個(gè)行政村為調(diào)查現(xiàn)場(chǎng),在社區(qū)衛(wèi)生服務(wù)中心和村衛(wèi)生室獲取高血壓患者名單,以60歲以上高血壓患者為調(diào)查對(duì)象,通過電話預(yù)約入戶詢問調(diào)查和血壓測(cè)量收集資料,實(shí)際共調(diào)查和測(cè)量1021例高血壓患者,獲得有效問卷856份,有效率為83.8%。本次調(diào)查采用自行設(shè)計(jì)的調(diào)查對(duì)象基本情況問卷和匹茲堡睡眠質(zhì)量指數(shù)量表,內(nèi)容包括調(diào)查對(duì)象的基本情況如年齡、性別、文化程度、醫(yī)保形式等問題;老年高血壓患者睡眠質(zhì)量。調(diào)查員經(jīng)過培訓(xùn)后以一對(duì)一的方式對(duì)調(diào)查對(duì)象進(jìn)行問卷調(diào)查,并按標(biāo)準(zhǔn)進(jìn)行血壓測(cè)量。按照《中國高血壓防治指南2010》將血壓分為正常血壓、正常高值血壓、1級(jí)高血壓、2級(jí)高血壓和3級(jí)高血壓5個(gè)等級(jí)。問卷核查后利用Epidata3.1和SPSS16.0進(jìn)行數(shù)據(jù)錄入和數(shù)據(jù)分析。結(jié)果(1)城市老年高血壓患者平均血壓水平為139.98/80.91mm Hg,農(nóng)村為141.25/80.64mm Hg,城鄉(xiāng)差異無統(tǒng)計(jì)學(xué)意義(P0.05);城市老年高血壓患者血壓分級(jí)水平以正常高值和1級(jí)高血壓水平為主,分別占38.9%、40.8%;農(nóng)村老年高血壓患者以正常高值和1級(jí)高血壓水平為主,分別占32.9%和43.5%,差異無統(tǒng)計(jì)意義(χ2=5.693,P=0.223);城市老年高血壓患者ISH比例為31.8%,農(nóng)村39.1%,差異有統(tǒng)計(jì)學(xué)意義(χ2=4.788,P=0.029)。(2)城市老年高血壓患者PSQI總體評(píng)分為7.31±3.96分,農(nóng)村PSQI總體評(píng)分為9.02±3.94分。城市與農(nóng)村老年高血壓患者在睡眠時(shí)間、睡眠障礙、入睡時(shí)間、睡眠效率、主觀睡眠質(zhì)量及PSQI總體評(píng)分等差異有統(tǒng)計(jì)學(xué)意義(P0.05),農(nóng)村老年高血壓患者在睡眠時(shí)間、睡眠障礙、睡眠效率、主觀睡眠質(zhì)量及PSQI總體評(píng)分方面得分高于城市,在入睡時(shí)間方面得分低于城市。(3)不同血壓分級(jí)水平老年高血壓患者在日間功能障礙方面差異有統(tǒng)計(jì)學(xué)意義(P0.05)。ISH患者與非ISH患者睡眠效率存在差異(P0.05),ISH患者睡眠質(zhì)量比非ISH患者差。老年高血壓患者PSQI總體評(píng)分和7個(gè)維度與SBP、DBP均無明顯相關(guān)性;但脈壓差與睡眠效率得分呈正相關(guān)。(4)單因素分析發(fā)現(xiàn)性別、文化層次、職業(yè)、醫(yī)保形式是老年高血壓患者睡眠質(zhì)量的影響因素;Logistic回歸分析發(fā)現(xiàn)女性、新型農(nóng)村合作醫(yī)療保險(xiǎn)患者、患高血壓≥5年、不服用降壓藥是睡眠質(zhì)量的危險(xiǎn)因素。結(jié)論(1)城市與農(nóng)村老年高血壓患者平均血壓水平略低,主要集中于正常高值水平和1級(jí)高血壓水平,ISH患者比例較高。且睡眠障礙發(fā)生率較高,農(nóng)村高于城市。(2)老年高血壓患者PSQI總體評(píng)分和7個(gè)維度得分與SBP、DBP均無明顯相關(guān)性。(3)老年高血壓患者日間功能障礙隨著血壓水平升高而加重,SBP波動(dòng)和脈壓差對(duì)老年高血壓患者睡眠效率有影響。(4)女性、文化層次低、從事體力勞動(dòng)者、新型農(nóng)村合作醫(yī)療保險(xiǎn)患者、患高血壓≥5年的老年人群、不服用降壓藥者睡眠質(zhì)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.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R544.1

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