梁荣绍　谢超　李涛

【摘要】 目的：探究维持性血液透析者发生睡眠情况持续下降的相关影响因素。方法：筛选135例维持性血液透析受试者，应用匹兹堡睡眠情况指数（PSQI）对受试者进行标准问卷调查，评估受试者的睡眠情况，记录受试者的血液透析方案、生液生化指标以及维持治疗的具体用药资料，分析影响其睡眠情况的诸因素。结果：62.22%的受试者均有不同程度的睡眠障碍。通过调研发现，受试者的每周透析时间、透析年限、血液滤过的总计次数、年龄、全段甲状旁腺激素（iPTH）、血红蛋白（Hb）、血钙磷乘积以及尿素清除指数（Kt/V）是血液透析者发生一定睡眠障碍的主要影响因素。其中，Hb、每周透析时间、外周血iPTH、Kt/V以及血钙磷乘积对睡眠的影响最显著。结论：维持性血液透析受试者存在不同程度的睡眠障碍，贫血、透析不够充分、血钙和血磷发生紊乱是诱发血液透析者睡眠障碍的关键危险因素。

【关键词】 维持性血液透析受试者； 睡眠情况； 相关因素； Logistic回顾分析

【Abstract】 Objective：To explore the related influencing factors of sleep quality in maintenance hemodialysis patients.Method：135 maintenance hemodialysis patients were screened.The researchers used the Pittsburgh sleep quality index （PSQI） to assess the sleep quality of the subjects by a standard questionnaire.The blood dialysis solution，biochemical indexes and maintenance treatment of subjects were recorded，the factors affect the quality of sleep were analyzed.Result：62.22% of the subjects had different levels of sleep disorder.Through the investigation，the researchers found that the subjects of the weekly time of dialysis，dialysis duration，total times of hemofiltration，age，total number of intact parathyroid hormone （iPTH），hemoglobin （Hb），the product of calcium and phosphorus and urea clearance index （Kt/V） were the main influencing factors of sleep disorder in hemodialysis patients.Among them，the most significant effects were Hb，weekly dialysis time，peripheral blood iPTH，Kt/V，the product of calcium and phosphorus on sleep.Conclusion：There are different levels of sleep disorder in maintenance hemodialysis patients.Anemia，inadequate dialysis，blood calcium and phosphorus disorder are the key risk of sleep disorder induced factors in hemodialysis patients.

【Key words】 Maintenance hemodialysis patients； Sleep quality； Related factors； Logistic retrospective analysis

First-authors address：Seventh Peoples Hospital of Nanhai District，Foshan 528200，China

doi：10.3969/j.issn.1674-4985.2017.04.039

血液透析属于终末期肾病者实施肾脏替代治疗的措施之一，其可有效延续肾病患者的生命[1-3]。然而众多研究发现，血液透析受试者存在不同程度的睡眠障碍，即某时间段内睡眠质量欠佳，临床症状表现为嗜睡、失眠、昼夜睡眠节律障碍、睡眠呼吸暂停、不宁腿综合征、周期性肢体运动障碍等。并且，该睡眠障碍与受试者的生活质量以及存活期限相关联[4-5]。研究显示，60%的维持性血液透析者有不同程度和类型的睡眠问题[6-7]。……