本文選題：睡眠 + 慢性高原病��； 參考：《解放軍醫(yī)學(xué)雜志》2017年06期

【摘要】：目的了解常駐高原部隊官兵的睡眠質(zhì)量情況,探討其與慢性高原病之間的關(guān)系。方法采用分層隨機抽樣的方法,從某軍區(qū)高原駐防部隊中抽取956名連續(xù)駐守高原6個月以上的男性軍人作為高原組,同時抽取該軍區(qū)在平原地區(qū)駐防的587名未進駐過高原的男性軍人作為對照組。采用匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)搜集研究對象的睡眠情況,采用慢性高原病(CMS)癥狀問卷并結(jié)合生理學(xué)檢查指標(biāo)確定是否存在CMS以及CMS的程度。比較高原組整體及其兩個亞組(健康亞組和CMS亞組)與對照組的各項生理指標(biāo)和PSQI量表評分的差異。分析高原組PSQI和CMS評分與其生理指標(biāo)的相關(guān)性,及其PSQI睡眠質(zhì)量各項評分與CMS評分的相關(guān)性,分析高原組中3個CMS亞組(健康、輕度、中重度)間PSQI各項分值和生理指標(biāo)的差異。結(jié)果高原組的收縮壓、心率和血紅蛋白濃度均明顯高于對照組(P0.05),血氧飽和度明顯低于對照組(P0.05);高原組PSQI各指標(biāo)分值均明顯高于對照組(P0.05)。在高原組中,健康亞組和CMS亞組的收縮壓、心率、血氧飽和度和血紅蛋白濃度均明顯高于對照組(P0.05),且CMS亞組的舒張壓明顯高于對照組(P0.05);除催眠藥物應(yīng)用這一指標(biāo)外,高原組中健康亞組和CMS亞組的PSQI各指標(biāo)均明顯高于對照組(P0.05)。在高原組中,睡眠時間分值與收縮壓呈明顯負相關(guān)(P0.05),睡眠效率分值與心率呈明顯負相關(guān)(P0.05),睡眠時間分值與血氧飽和度呈明顯正相關(guān)(P0.05);CMS評分與收縮壓、舒張壓、心率、血紅蛋白濃度呈明顯正相關(guān)(P0.05),與血氧飽和度呈明顯負相關(guān)(P0.05);除催眠藥物應(yīng)用這一指標(biāo)外,PSQI各項評分與CMS評分均呈明顯正相關(guān)(P0.05)。在高原組的3個亞組中,輕度和中重度CMS亞組的血氧飽和度明顯低于健康亞組(P0.05),而血紅蛋白濃度明顯高于健康亞組(P0.05);輕度、中重度CMS亞組睡眠障礙、PSQI總分分值明顯高于健康亞組(P0.05),而中重度CMS亞組的睡眠質(zhì)量、睡眠時間、睡眠效率和日間功能紊亂分值明顯高于健康亞組和輕度CMS亞組(P0.05)。結(jié)論常駐高原部隊官兵的睡眠質(zhì)量與對照組比較明顯降低,不僅與高原生活工作經(jīng)歷有關(guān),也與CMS相關(guān)。隨著CMS癥狀的加重,睡眠質(zhì)量不斷下降,尤以睡眠效率、睡眠障礙、PSQI總分分值的下降為著。在改善常駐高原部隊官兵睡眠質(zhì)量的同時須加強對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.
【作者單位】： 第三軍醫(yī)大學(xué)衛(wèi)勤訓(xùn)練基地 衛(wèi)生勤務(wù)學(xué)教研室;第三軍醫(yī)大學(xué)高原醫(yī)學(xué)系 高原環(huán)境醫(yī)學(xué)教育部重點實驗室 全軍高原生理與高原病研究重點實驗室 高原特需藥品與衛(wèi)生裝備研究室;
【基金】：國家基礎(chǔ)科學(xué)人才培養(yǎng)基金(J1310001) 全軍“十二五”重大課題(AWS14C007) 全軍“十二五”重點課題(EWS11J042)~~
【分類號】：R82

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