老年人睡眠质量及睡眠时长与动态心电图校正的QT间期的关联分析

doi:10.12114/j.issn.1007-9572.2021.00.495

摘要/Abstract

摘要： 背景　睡眠对于维持人体健康至关重要，睡眠质量和睡眠时长与多种疾病发生相关。既往职业人群研究表明，睡眠剥夺与QT间期延长相关。但关于一般人群中睡眠质量、睡眠时长与校正的QT间期（QTc）关联的研究较少。目的　探讨中国老年人群睡眠质量及睡眠时长与QTc的关联。方法　选取2017年11—12月如皋市长寿和衰老队列（RuLAS）的睡眠和心电图数据，并根据匹兹堡睡眠质量指数量表（PSQI）评分将老年人分为睡眠正常组（n=776）、睡眠质量轻度下降组（n=214例）、睡眠质量下降组（n=152例）；通过静息心电图（ECG）仪的解读程序收集ECG参数〔QTc、心率（HR）、P波、QRS间期、PR间期、V5导联的R波（RV5）、V1导联的S波（SV1）〕。采用多重线性回归分析探讨PSQI评分与QTc的影响因素。结果　老年人PSQI评分为（4.6±2.6）分，夜间睡眠时长为（9.2±1.8）h。3组间性别、受教育程度、饮酒情况、糖尿病患病情况、认知功能评分、体力活动评分、QTc、RV5比较，差异均有统计学意义（P<0.05）。校正多种混杂因素后，多重线性回归分析显示，PSQI评分〔β=1.63，95%CI（0.23，3.04），P=0.023〕，≤6 h〔β=21.22，95%CI（6.28，36.16），P=0.005〕的睡眠时长、>10 h〔β=8.81，95%CI（0.24，17.39），P=0.044〕的睡眠时长是QTc的影响因素。结论　中国老年人群睡眠质量差、睡眠时长过长或过短与QTc相关，提示睡眠质量及时长可能是QTc的影响因素之一，改善睡眠可能预防QTc延长，从而预防心源性死亡。

关键词: 睡眠, 睡眠质量, 睡眠时长, QTc, 心血管疾病, 老年人, 相关性分析

Abstract: Background　Sleep is essential for maintaining human health.The quality and duration of sleep are associated with the occurrence of many diseases.Previous studies showed that sleep deprivation was associated with prolonged QT interval in occupational groups.However，there is no study on the association of sleep quality and sleep duration with corrected QTc interval（QTc）in the general population.Objective　To explore the association of sleep quality and sleep duration with QTc in Chinese older adults.Methods　From November to December 2017，the data on electrocardiogram（ECG）and sleep of Rugao Longevity and Aging Cohort Study were selected.According to the Pittsburgh Sleep Quality Index（PSQI）score，the participants were divided into normal sleep group（n=776），mildly impaired sleep quality group（n=214），and poor sleep quality group（n=152）.ECG parameters were collected by interpreting the resting ECG 〔including QTc，heart rate，atrial depolarization wave，QRS interval，the time interval from the end of the P wave to the beginning of the QRS complex，R wave in lead V5（RV5），and S wave in lead V1〕．Multiple linear regression analysis was used to explore the factors associated with the PSQI score and QTc.Results　The mean PSQI score of the participants was（4.6±2.6）points，and the mean night sleep duration was（9.2±1.8）hours.Three groups showed significant differences in the distribution of gender，education level，alcohol consumption，cognitive function，physical activity，QTc and RV5，as well as diabetes prevalence（P<0.05）.After adjusting for multiple confounding factors，multiple linear regression analysis showed that the PSQI score〔β=1.63，95%CI（0.23，3.04），P=0.023〕，sleep duration ≤6 h〔β=21.22，95%CI（6.28，36.16），P=0.005〕and sleep duration >10 h 〔β=8.81，95%CI（0.24，17.39），P=0.044〕 were associated with the QTc.Conclusion　Poor sleep quality，long or short sleep duration were associated with QTc in Chinese elderly people，suggesting that sleep quality and sleep duration may be associated factors of QTc，and improving quality of sleep may prevent QTc prolongation，thereby preventing cardiac death.

Key words: Sleep, Sleep quality, Sleep duration, QTc, Cardiovascular, Aged, Correlation analysis

王晓旭,石建明,蒋晓燕,等. 老年人睡眠质量及睡眠时长与动态心电图校正的QT间期的关联分析[J]. 中国全科医学, 2021, 24(17): 2157-2162. DOI: 10.12114/j.issn.1007-9572.2021.00.495.
WANG Xiaoxu,SHI Jianming,JIANG Xiaoyan, et al. Associations of Sleep Quality and Sleep Duration with Corrected QTc Interval on the Ambulatory Electrocardiogram　[J]. Chinese General Practice, 2021, 24(17): 2157-2162. DOI: 10.12114/j.issn.1007-9572.2021.00.495.

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