摘要目的 调查睡眠质量对慢性阻塞性肺疾病(慢阻肺)患者系统性炎症水平的影响及其与慢阻肺急性加重次数的相关性分析.方法 回顾性分析安徽医科大学附属第一医院2016年10月至2017年6月住院慢阻肺患者198例,纳入符合入组条件的124例.所有患者于入院第1天采集血标本,检测白细胞、淋巴细胞、血小板计数及C反应蛋白,完成睡眠指数量表(PSQI)调查及其他临床资料的采集,将PQSI评分>5分定义为低睡眠质量,根据PQSI将患者分为慢阻肺对照组[39例,其中男27例,女13例,年龄(68 ±10)岁]和低睡眠质量组[85例,其中男52例,女33例,年龄(72 ±8)岁].收集同期本院体检中心健康体检者51名,均完成PSQI评分,根据PSQI分为低睡眠质量对照组[23名,其中男18名,女5名,年龄(67 ±8)岁]及健康对照组[28名,其中男14名,女14名,年龄(69 ±7)岁].比较各组系统性炎症因子水平及慢阻肺患者1年内急性加重次数.结果 124例慢阻肺患者中89例主诉至少在过去1年及更长时间内存在睡眠质量异常;低睡眠质量组过去1年中住院次数为2(1,4)次,与对照组[1(0,2)次]比较更高,差异有统计学意义(P<0.05);与对照组比较,低睡眠质量组外周血中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及C反应蛋白均显著性增高,差异均有统计学意义(P<0.05);低睡眠质量组外周血中NLR、PLR、C反应蛋白与PSQI值呈正相关,C 反应蛋白及 PSQI 与慢阻肺患者过去1年中急性加重次数呈正相关(r =0.483、0.430).结论 睡眠质量异常在慢阻肺患者中发生率较高,睡眠质量与慢阻肺患者急性加重时系统性炎症水平相关,低睡眠质量与慢阻肺患者急性加重的次数呈正相关.

abstractsObjective To investigate the association of sleep quality with the levels of systemic inflammatory markers in patients with chronic obstructive pulmonary disease (COPD) and the correlations between the frequency of acute exacerbation of COPD (AECOPD) and Pittsburgh sleep quality index (PSQI).Methods A total of 198 COPD patients admitted in our hospital from October,2016 to June, 2017 were screened,and 124 patients were eligible for the study.On the first day of hospitalization, the serum samples and clinical data were collected, including white blood cells, lymphocytes, platelet count, CRP and PSQI.Poor sleep quality was defined as PSQI score >5.Results The percentage of COPD patients with poor sleep quality was about 68%.Poor sleep quality was positively correlated with the frequency of acute exacerbation in COPD patients.The ratio of neutrophil to lymphocyte (NLR), ratio of platelet to lymphocyte (PLR) and levels of CRP were higher in patients with poor sleep quality than those in the control group.NLR, PLR and CRP in peripheral blood of the patients with poor sleep quality were positively correlated with PSQI score.The CRP levels and PSQI score in COPD patients with poor sleep quality group were positively correlated with the frequency of exacerbations in the past year (r=0.437,r=0.430).Conclusion A high percentage of COPD patients had poor sleep quality, which was positively correlated with the levels of systemic inflammation as well as the frequency of AECOPD.