【摘要】 目的调查中国肌萎缩侧索硬化(ALS)患者睡眠障碍的发生情况,了解医师对此类患者伴发睡眠相关问题的重视程度。方法对2007-11-01—2011-10-31北京大学第三医院神经内科新诊断为ALS的396例中国患者进行以电话为主要手段的随访,调查指南推荐的主要非药物治疗措施使用情况;采用匹兹堡睡眠质量指数(PSQI)量表中睡眠质量主观评价、入睡状况和早醒3个条目进行调查;焦虑抑郁状态采用综合性医院焦虑抑郁量表(HADS)进行调查,以HADS≥8分判定存在焦虑抑郁状态;调查医师对患者睡眠相关问题的关注程度。结果 396例ALS患者使用经皮胃造瘘(PEG)10例(2.5%),使用双水平正压通气(BiPAP)19例(4.8%)。不同病程的ALS患者PEG和BiPAP使用率比较,差异均无统计学意义(P>0.05)。396例患者发病后睡眠质量降低246例(62.1%),对近1个月睡眠状况不满意201例(50.8%),入睡超过30 min 154例(38.9%),早醒或易醒148例(37.4%),HADS≥8分245例(61.9%)。不同病程的ALS患者发病后睡眠质量降低和早醒或易醒的发生率比较,差异均有统计学意义(P<0.05);不同病程的ALS患者对近1个月睡眠状况不满意、入睡超过30 min、HADS≥8分的发生率比较,差异均无统计学意义(P>0.05)。曾有医生主动询问患者睡眠相关问题27例(6.8%);患者曾在医生指导下使用过安眠或助眠药物19例(4.8%)。结论目前,在我国有相当一部分ALS患者存在睡眠相关问题,并且国内医师对这种状况的重视程度明显不足,应尽快提高对ALS伴发的睡眠相关问题的重视。更多还原

【Abstract】 Objective To investigate the sleeping quality and influencing factors in Chinese patients with amyotrophic lateral sclerosis(ALS),and to understand the attitude of doctors to sleeping problems in patients with ALS.Methods A total of 396 newly diagnosed ALS patients in Department of Neurology,Peking University Third Hospital from November 1st,2007 to October 31st,2011 were followed up by telephone in order to understand non-drug treatment,subjective evaluation of sleep quality according to PSQI,sleep latency and early awakening.The anxiety and depression scale were investigated by using HADS,with HADS≥8 being in anxiety and depression condition.The attention paid by doctors to the patients was also investigated.Results Among the 396 patients,10 cases(2.5%) used PEG,19 cases(4.8%) used BiPAP.The use rate of ALS patients with different courses of disease showed no statistically significant difference(P > 0.05).After onset of ALS,246 cases(62.1%) had worse sleep quality,201 cases(50.8%) were not satisfied with their sleep over the past one month,154 cases(38.9%) had prolonged sleep latency,148 cases(37.3%) had early awakening or easy awakening and 245 cases(61.9%) had HADS≥8.The sleep quality and early or easy awakening in patients with different courses of disease showed statistically significant differences(P < 0.05).The dissatisfaction with sleep quality over the past one month,prolonged sleep latency and patients with HADS≥8 in patients with different courses of disease showed no statistically significant difference(P > 0.05).27 cases(6.8%) were once asked about sleep quality by doctors,and 19 cases(4.8%) were guided by doctors in using sleeping pills.Conclusion The disorders relevant to sleep are general among Chinese patients with ALS,and it may relate to the high proportion of anxiety and depression and the clinical symptoms of ALS.Currently,doctors are not paying enough attention to the situation.更多还原