山东大学耳鼻喉眼学报 ›› 2022, Vol. 37 ›› Issue (6): 93-100.doi: 10.6040/j.issn.1673-3770.0.2022.105
黄维洁,魏然,周玉红,邓应平
HUANG Weijie, WEI Ran, ZHOU Yuhong, DENG Yingping
摘要: 目的 评估干眼患者的睡眠质量及情绪状态,并分析干眼临床特征与睡眠质量及情绪状态的关系。 方法 纳入就诊于四川大学华西医院眼科门诊的干眼患者70例,同时选取年龄和性别匹配的40例健康受试者作为对照组。对所有受试者使用中文版匹兹堡睡眠质量指数量表(Chinese version of the Pittsburgh sleep quality index, CPSQI)、Epworth嗜睡量表及失眠严重程度指数量表(insomnia severity index, ISI)评估睡眠质量,汉密尔顿焦虑量表(Hamilton anxiety scale, HAMA)及汉密尔顿抑郁量表(Hamilton depression scale, HAMD)评估情绪状态,眼表疾病指数量表(ocular surface disease index, OSDI)评估干眼症状;利用双通道客观视觉质量分析系统Ⅱ测量泪膜动态变化和客观视觉质量;LipiView® Ⅱ眼表干涉仪获取不全眨眼比例(partial blink rate, PBR)、脂质层厚度(lipid layer thickness, LLT)和睑板腺缺失程度;同时测量泪膜破裂时间(fluorescein breakup time, FBUT)、角膜染色评分(corneal fluorescein staining, CFS)和泪液分泌试验(schirmer Ⅰ test, SⅠt)。 结果 干眼患者的CPSQI总分(P<0.001)及其组成因子评分、ISI评分(P<0.001)、HAMA评分(P<0.001)和HAMD评分(P=0.001)均明显高于对照组,差异均有统计学意义。睡眠质量差与睡眠质量良好的干眼患者比较,OSDI评分较高(P=0.046),SⅠt较低(P=0.032),差异均有统计学意义。睡眠质量差的干眼患者ISI评分(P<0.001)、HAMA评分(P=0.001)和HAMD评分(P<0.001)更高。相关性分析显示,OSDI评分与CPSQI总分、主观睡眠质量评分和入睡时间均呈正相关;SⅠt与CPSQI总分、主观睡眠质量、入睡时间和睡眠效率评分均呈负相关;FBUT与睡眠效率评分呈负相关;CFS与睡眠时间呈负相关,与睡眠障碍呈正相关。OSDI评分还与ISI评分和HAMA评分呈正相关。 结论 睡眠质量差在干眼患者较普遍,且可能伴随焦虑及抑郁。睡眠障碍可能伴随泪液分泌减少、泪膜不稳定、角膜损伤较重或心理负担增加,影响干眼的发生和发展。
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