中国全科医学 ›› 2020, Vol. 23 ›› Issue (29): 3712-3718.DOI: 10.12114/j.issn.1007-9572.2020.00.107
所属专题: 睡眠研究最新文章合辑; 睡眠问题专题研究
刘美君,崔文鹏,苗里宁,赵晶,周文华*
出版日期:
2020-10-15
发布日期:
2020-10-15
基金资助:
LIU Meijun,CUI Wenpeng,Miao Lining,ZHAO Jing,ZHOU Wenhua*
Published:
2020-10-15
Online:
2020-10-15
摘要: 睡眠障碍是维持性血液透析(MHD)患者的常见并发症之一,其临床症状隐匿,且严重影响患者的生活质量与远期预后。MHD患者发生睡眠障碍的具体机制尚未明确,可能与患者自身生活习惯、心理因素、其他并发症、电解质代谢紊乱等相关。并且针对MHD患者睡眠障碍的预防及治疗也无统一标准。本文基于相关研究,拟就MHD患者睡眠障碍临床症状、病因及治疗进展做一综述,以期为临床医生对MHD患者睡眠障碍的治疗提供新思路。
[1]MUCSI I,MOLNAR M Z,RETHELYI J,et al.Sleep disorders and illness intrusiveness in patients on chronic dialysis[J].Nephrol Dial Transplant,2004,19(7):1815-1822.DOI:10.1093/ndt/gfh130. [2]LOSSO R L,MINHOTO G R,RIELLA M C.Sleep disorders in patients with end-stage renal disease undergoing dialysis:comparison between hemodialysis,continuous ambulatory peritoneal dialysis and automated peritoneal dialysis[J].Int Urol Nephrol,2015,47(2):369-375.DOI:10.1007/s11255-014-0860-5. [3]EZZAT H,MOHAB A.Prevalence of sleep disorders among ESRD patients[J].Ren Fail,2015,37(6):1013-1019.DOI:10.3109/0886022X.2015.1044401. [4]NARITA I,IGUCHI S,OMORI K,et al.Uremic pruritus in chronic hemodialysis patients[J].J Nephrol,2008,21(2):161-165.DOI:10.1080/00397919708006087. [5]ROUMELIOTI M E,ARGYROPOULOS C,BUYSSE D J,et al.Sleep quality,mood,alertness and their variability in CKD and ESRD[J].Nephron Clin Pract,2010,114(4):c277-287.DOI:10.1159/000276580. [6]KOPPLE J D,SHAPIRO B B,FEROZE U,et al.Hemodialysis treatment engenders anxiety and emotional distress?[J].Clin Nephrol,2017,88(10):205-217.DOI:10.5414/CN109112. [7]杜晓霞,任孝鹏.维持性透析患者的睡眠情况调查[J].中国血液净化,2006,5(12):832-834.DOI:10.3969/j.issn.1671-4091.2006.12.005. DU X X,REN X P.The investigation of sleep quality in maintenance haemodialysis patients[J].Chinese Journal of Blood Purification,2006,5(12):832-834.DOI:10.3969/j.issn.1671-4091.2006.12.005. [8]ORASAN O H,SAPLONTAI A P,COZMA A,et al.Insomnia,muscular cramps and pruritus have low intensity in hemodialysis patients with good dialysis efficiency,low inflammation and arteriovenous fistula[J].Int Urol Nephrol,2017,49(9):1673-1679.DOI:10.1007/s11255-017-1624-9. [9]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540.DOI:10.3760/cma.j.issn.1006-7876.2012.07.022.http://www.302hospital.com/userfiles/files/phpdo10020160725092503.pdf. [10]NOVAK M,SHAPIRO C M,MENDELSSOHN D,et al.Diagnosis and management of insomnia in dialysis patients[J].Semin Dial,2006,19(1):25-31.DOI:10.1111/j.1525-139X.2006.00116.x. [11]ORASAN O H,SAPLONTAI A P,COZMA A,et al.Insomnia,muscular cramps and pruritus have low intensity in hemodialysis patients with good dialysis efficiency,low inflammation and arteriovenous fistula[J].Int Urol Nephrol,2017,49(9):1673-1679.DOI:10.1007/s11255-017-1624-9. [12]AFSAR B,ELSURER R.Association between serum bicarbonate and pH with depression,cognition and sleep quality in hemodialysis patients[J].Ren Fail,2015,37(6):957-960.DOI:10.3109/0886022X.2015.1038476. [13]何权瀛,陈宝元.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)解读[J].中华结核和呼吸杂志,2012,35(1):7-8.DOI:10.3760/cma.j.issn.1001-0939.2012.01.006. [14]喻淑慧,胡克.睡眠呼吸障碍与慢性肾脏病的研究进展[J].临床肺科杂志,2017,22(9):1702-1706.DOI:10.3969/j.issn.1009-6663.2017.09.044. [15]浦柳美,黄国兰,鲁立文.维持性血液透析患者发生阻塞性睡眠呼吸暂停低通气综合征与血脂水平关系研究[J].临床荟萃,2018,33(7):599-602.DOI:10.3969/j.issn.1004-583X.2018.07.011. PU L M,HUANG G L,LU L W.Relationship between obstructive sleep apnea and blood lipid level in maintenance hemodialysis patients[J].Clin Focus,2018,33(7):599-602.DOI:10.3969/j.issn.1004-583X.2018.07.011. [16]王翔,朱艳,杨帅帅,等.慢性肾脏疾病与睡眠呼吸暂停综合征关系的研究进展[J].医学综述,2015,21(19):3567-3569.DOI:10.3969/j.issn.1006-2084.2015.19.041. WANG X,ZHU Y,YANG S S,et al.Research progress about chronic kidney disease and sleep apnea syndrome[J].Med Recapitul,2015,21(19):3567-3569.DOI:10.3969/j.issn.1006-2084.2015.19.041. [17]谢敏妍,刘海俊,陈锦华,等.透析充分性、微炎症、营养状态对血液透析患者生存质量及长期生存率的影响[J].现代生物医学进展,2014,14(23):4532-4536,4544.DOI:10.13241/j.cnki.pmb.2014.23.037. XIE M Y,LIU H J,CHEN J H,et al.The effect of dialysis adequacy,microinflammation and nutritional status on the quality of life and survival rate in maintenance hemodialysis patients[J].Progress in Modern Biomedicine,2014,14(23):4532-4536,4544.DOI:10.13241/j.cnki.pmb.2014.23.037. [18]NOVAK M,MENDELSSOHN D,SHAPIRO C M,et al.Diagnosis and management of sleep apnea syndrome and restless legs syndrome in dialysis patients[J].Semin Dial,2006,19(3):210-216.DOI:10.1111/j.1525-139X.2006.00157.x. [19]ALLEN R P,PICCHIETTI D L,GARCIA-BORREGUERO D,et al.Restless legs syndrome/Willis-ekbom disease diagnostic criteria:updated international restless legs syndrome study group(IRLSSG) consensus criteria——history,rationale,description,and significance[J].Sleep Med,2014,15(8):860-873.DOI:10.1016/j.sleep.2014.03.025. [20]NOVAK M,WINKELMAN J W,UNRUH M.Restless legs syndrome in patients with chronic kidney disease[J].Semin Nephrol,2015,35(4):347-358.DOI:10.1016/j.semnephrol.2015.06.006. [21]马烈,孙斌.不宁腿综合征发病机制的研究进展[J].中华内科杂志,2006,45(4):336-337.DOI:10.3760/j.issn:0578-1426.2006.04.033. [22]SCHORMAIR B,PLAG J,KAFFE M,et al.MEIS1 and BTBD9:genetic association with restless leg syndrome in end stage renal disease[J].J Med Genet,2011,48(7):462-466.DOI:10.1136/jmg.2010.087858. [23]LI G,TANG H D,WANG C,et al.Association of BTBD9 and MAP2K5/SKOR1 with restless legs syndrome in Chinese population[J].Sleep,2017,40(4):zsx028.DOI:10.1093/sleep/zsx028. [24]LIN C H,CHEN M L,WU V C,et al.Association of candidate genetic variants with restless legs syndrome in end stage renal disease:a multicenter case-control study in Taiwan[J].Eur J Neurol,2014,21(3):492-498.DOI:10.1111/ene.12337. [25]KUTNER N G,ZHANG R,HUANG Y J,et al.Racial differences in restless legs symptoms and serum ferritin in an incident dialysis patient cohort[J].Int Urol Nephrol,2012,44(6):1825-1831.DOI:10.1007/s11255-011-0108-6. [26]王秀川,朱卫国.慢性肾脏病患者不宁腿综合征研究进展[J].中国血液净化,2018,17(1):54-56.DOI:10.3969/j.issn.1671-4091.2018.01.013. [27]SIDDIQUI S,KAVANAGH D,TRAYNOR J,et al.Risk factors for restless legs syndrome in Dialysis patients[J].Nephron Clin Pract,2005,101(3):c155-160.DOI:10.1159/000087073. [28]COLLADO-SEIDEL V,KOHNEN R,SAMTLEBEN W,et al.Clinical and biochemical findings in uremic patients with and without restless legs syndrome[J].Am J Kidney Dis,1998,31(2):324-328.DOI:10.1053/ajkd.1998.v31.pm9469505. [29]PATRICK L R.Restless legs syndrome:pathophysiology and the role of iron and folate[J].Altern Med Rev,2007,12(2):101-112.DOI:10.1016/j.jep.2007.03.028. [30]NARITA I,IGUCHI S,OMORI K,et al.Uremic pruritus in chronic hemodialysis patients[J].J Nephrol,2008,21(2):161-165.DOI:10.1080/00397919708006087. [31]MATHUR V S,LINDBERG J,GERMAIN M,et al.A longitudinal study of uremic pruritus in hemodialysis patients[J].Clin J Am Soc Nephrol,2010,5(8):1410-1419.DOI:10.2215/CJN.00100110. [32]KIMATA N,FULLER D S,SAITO A,et al.Pruritus in hemodialysis patients:results from the Japanese dialysis outcomes and practice patterns study(JDOPPS)[J].Hemodial Int,2014,18(3):657-667.DOI:10.1111/hdi.12158. [33]FALLAHZADEH M K,ROOZBEH J,GERAMIZADEH B,et al.Interleukin-2 serum levels are elevated in patients with uremic pruritus:a novel finding with practical implications[J].Nephrol Dial Transplant,2011,26(10):3338-3344.DOI:10.1093/ndt/gfr053. [34]HSU C W,WENG C H,CHAN M J,et al.Association between serum aluminum level and uremic pruritus in hemodialysis patients[J].Sci Rep,2018,8(1):17251.DOI:10.1038/s41598-018-35217-6. [35]赵景宏,王沂芹,王代红.尿毒症瘙痒症的发病机制与治疗进展[J].中华肾病研究电子杂志,2014,3(3):143-146.DOI:10.3877/cma.j.issn.2095-3216.2014.03.006. ZHAO J H,WANG Y Q,WANG D H.Progress in the pathogenesis and treatment of uremic pruritus[J].Chinese Journal of Kidney Disease Investigation(Electronic Version),2014,3(3):143-146.DOI:10.3877/cma.j.issn.2095-3216.2014.03.006. [36]KO M J,PENG Y S,CHEN H Y,et al.Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis[J].J Am Acad Dermatol,2014,71(6):1151-1159.e1.DOI:10.1016/j.jaad.2014.08.004. [37]WILLIAMS J,ROTH A,VATTHAUER K,et al.Cognitive behavioral treatment of insomnia[J].Chest,2013,143(2):554-565.DOI:10.1378/chest.12-0731. [38]YANG B,XU J R,XUE Q,et al.Non-pharmacological interventions for improving sleep quality in patients on dialysis:systematic review and meta-analysis[J].Sleep Med Rev,2015,23:68-82.DOI:10.1016/j.smrv.2014.11.005. [39]侯永梅,胡佩诚,梁燕萍,等.认知行为治疗改善维持性血液透析患者失眠的疗效[J].中国心理卫生杂志,2009,23(8):538-542,553.DOI:10.3969/j.issn.1000-6729.2009.08.002. HOU Y M,HU P C,LIANG Y P,et al.Effects of cognitive behavior therapy on insomnia of maintained hemodialysis patients:a randomly controlled study[J].Chinese Mental Health Journal,2009,23(8):538-542,553.DOI:10.3969/j.issn.1000-6729.2009.08.002. [40]DUARTE P S,MIYAZAKI M C,BLAY S L,et al.Cognitive–behavioral group therapy is an effective treatment for major depression in hemodialysis patients[J].Kidney Int,2009,76(4):414-421.DOI:10.1038/ki.2009.156. [41]KOCH B C,NAGTEGAAL J E,HAGEN E C,et al.Different melatonin rhythms and sleep-wake rhythms in patients on peritoneal dialysis daytime hemodialysis and nocturnal hemodialysis[J].Sleep Med,2010,11(3):242-246.DOI:10.1016/j.sleep.2009.04.006. [42]PARKER K P,BAILEY J L,RYE D B,et al.Insomnia on dialysis nights:the beneficial effects of cool dialysate[J].J Nephrol,2008,21(Suppl 13):S71-77.DOI:10.1007/s00421-007-0667-5. [43]AYOUB A,FINLAYSON M.Effect of cool temperature dialysate on the quality and patients' perception of haemodialysis[J].Nephrol Dial Transplant,2004,19(1):190-194.DOI:10.1093/ndt/gfg512. [44]PROVENZANO R,SAWAYA B,FRINAK S,et al.The effect of cooled dialysate on thermal energy balance in hemodialysis patients[J].ASAIO Trans,1988,34(3):515-518. [45]赵庞艳,闫松.透析不同时期加入血液灌流治疗尿毒症的疗效评价[J].蚌埠医学院学报,2018,43(3):404-406.DOI:10.13898/j.cnki.issn.1000-2200.2018.03.037. ZHAO P Y,YAN S.Clinical efficacy of hemoperfusion at different stages in the treatment of uremia[J].Journal of Bengbu Medical College,2018,43(3):404-406.DOI:10.13898/j.cnki.issn.1000-2200.2018.03.037. [46]范文奎,杨红,梁艳影.联机血液透析滤过对尿毒症皮肤瘙痒治疗的临床研究[J].中国中西医结合肾病杂志,2003,4(6):345-346.DOI:10.3969/j.issn.1009-587X.2003.06.014. [47]梁荣绍,谢超,李涛,等.维持性血液透析受试者睡眠情况下降的相关因素调查Logistic回顾分析[J].中国医学创新,2017,14(4):136-139.DOI:10.3969/j.issn.1674-4985.2017.04.039. LIANG R S,XIE C,LI T,et al.Logistic retrospective analysis of the related factors of sleep quality in maintenance hemodialysis patients[J].Medical Innovation of China,2017,14(4):136-139.DOI:10.3969/j.issn.1674-4985.2017.04.039. [48]BUGEJA A,DACOURIS N,THOMAS A,et al.In-center nocturnal hemodialysis:another option in the management of chronic kidney disease[J].Clin J Am Soc Nephrol,2009,4(4):778-783.DOI:10.2215/CJN.05221008. [49]彭克秀,余均,唐浩文,等.中心夜间血液透析与传统血液透析治疗终末期肾病有效性的Meta分析[J].解放军医学院学报,2018,39(7):621-627.DOI:10.3969/j.issn.2095-5227.2018.07.019. PENG K X,YU J,TANG H W,et al.Comparison of nocturnal hemodialysis and conventional hemodialysis for end-stage renal disease:a meta-analysis and systematic review[J].Academic Journal of Chinese Pla Medical School,2018,39(7):621-627.DOI:10.3969/j.issn.2095-5227.2018.07.019. [50]孙博,汤晓静,申嫒文,等.夜间血液透析对维持性血液透析患者透析并发症和耐受性的影响[J].第二军医大学学报,2017,38(8):973-977.DOI:10.16781/j.0258-879x.2017.08.0973. SUN B,TANG X J,SHEN A W,et al.Effect of nocturnal hemodialysis on dialysis complications and tolerability in maintenance hemodialysis patients[J].Academic Journal of Second Military Medical University,2017,38(8):973-977.DOI:10.16781/j.0258-879x.2017.08.0973. [51]HANLY P J,PIERRATOS A.Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis[J].N Engl J Med,2001,344(2):102-107.DOI:10.1056/NEJM200101113440204. [52]袁艳辉,戎殳,张翼翔,等.透析中心夜间血液透析对尿毒症患者血磷代谢的影响[J].中国血液净化,2014,13(3):140-142,160.DOI:10.3969/j.issn.1671-4091.2014.03.004. YUAN Y H,RONG S,ZHANG Y X,et al.In-center nocturnal hemodialysis on phosphate metabolism in uremic patients[J].Chinese Journal of Blood Purification,2014,13(3):140-142,160.DOI:10.3969/j.issn.1671-4091.2014.03.004. [53]DAUGIRDAS J T,GREENE T,ROCCO M V,et al.Effect of frequent hemodialysis on residual kidney function[J].Kidney Int,2013,83(5):949-958.DOI:10.1038/ki.2012.457. [54]张以勤,叶婧,周丽娜,等.高通量血液透析对透析患者睡眠障碍的治疗效果研究[J].中国医师杂志,2016,18(6):917-919.DOI:10.3760/cma.j.issn.1008-1372.2016.06.035. [55]EL-WAKIL H S,ABOU-ZEID A A,EL-GOHARY I E,et al.Effect of high flux versus low flux hemodialysis on serum beta-2 microglobulin,advanced oxidation protein products and protein carbonyl[J].Alexandria Journal of Medicine,2011,47(1):37-42.DOI:10.1016/j.ajme.2011.04.004. [56]KHODAYAR O,RASOL K,SAYED R B,et al.High-flux and low-flux membranes:efficacy in hemodialysis[J].Nurs Midwifery Stud,2014,3(3):e21764.DOI:10.17795/nmsjournal21764. [57]MANDOLFO S,MALBERTI F,IMBASCIATI E,et al.Impact of blood and dialysate flow and surface on performance of new polysulfone hemodialysis dialyzers[J].Int J Artif Organs,2003,26(2):113-20.DOI:10.1177/039139880302600204. [58]MERLINO G,PIANI A,DOLSO P,et al.Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy[J].Nephrol Dial Transplant,2006,21(1):184-190.DOI:10.1093/ndt/gfi144. [59]KOCH B C,NAGTEGAAL J E,KERKHOF G A,et al.Circadian sleep-wake rhythm disturbances in end-stage renal disease[J].Nat Rev Nephrol,2009,5(7):407-416.DOI:10.1038/nrneph.2009.88. [60]MERLINO G,PIANI A,DOLSO P,et al.Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy[J].Nephrol Dial Transplant,2006,21(1):184-190.DOI:10.1093/ndt/gfi144. [61]SLOAND J A,SHELLY M A,FEIGIN A,et al.A double-blind,placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome[J].Am J Kidney Dis,2004,43(4):663-670.DOI:10.1053/j.ajkd.2003.11.021. [62]SABBATINI M,MINALE B,CRISPO A,et al.Insomnia in maintenance haemodialysis patients[J].Nephrol Dial Transplant,2002,17(5):852-856.DOI:10.1093/ndt/17.5.852. [63]TELES F,AZEVEDO V F,MIRANDA C T,et al.Depression in hemodialysis patients:the role of dialysis shift[J].Clinics(Sao Paulo),2014,69(3):198-202.DOI:10.6061/clinics/2014(03)10. [64]CENGIC B,RESIC H.Depression in hemodialysis patients[J].Bosn J Basic Med Sci,2010,10(1):73.DOI:10.17305/bjbms.2010.2653. [65]AL-JAHDALI H H,KHOGEER H A,AL-QADHI W A,et al.Insomnia in chronic renal patients on dialysis in saudi Arabia[J].J Circadian Rhythms,2010,8:7.DOI:10.1186/1740-3391-8-7. [66]HSU C Y,LEE C T,LEE Y J,et al.Better sleep quality and less daytime symptoms in patients on evening hemodialysis:a questionnaire-based study[J].Artif Organs,2010,32(9):711-716.DOI:10.1111/j.1525-1594.2008.00593.x. [67]BATHLA N,AHMAD S,GUPTA R,et al.Prevalence and predictors of poor sleep quality in patients on maintenance hemodialysis[J].Sleep Vigilance,2017,1(1):31-36.DOI:10.1007/s41782-017-0007-8. [68]ZHENG C F,XU J L,CHEN C S,et al.Effects of sleep disorders and sedative-hypnotic medications on health-related quality of life in dialysis patients[J].Int Urol Nephrol,2019,51(1):163-174.DOI:10.1007/s11255-018-2018-3. [69]SASAI T,INOUE Y,KOMADA Y,et al.Effects of insomnia and sleep medication on health-related quality of life[J].Sleep Med,2010,11(5):452-457.DOI:10.1016/j.sleep.2009.09.011. [70]KRIPKE D F,LANGER R D,KLINE L E.Hypnotics' association with mortality or cancer:a matched cohort study[J].BMJ Open,2012,2(1):e000850.DOI:10.1136/bmjopen-2012-000850. [71]WEICH S,PEARCE H L,CROFT P,et al.Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards:retrospective cohort study[J].BMJ,2014,348:g1996.DOI:10.1136/bmj.g1996. [72]PALMARO A,DUPOUY J,LAPEYRE-MESTRE M.Benzodiazepines and risk of death:results from two large cohort studies in France and UK[J].Eur Neuropsychopharmacol,2015,25(10):1566-1577.DOI:10.1016/j.euroneuro.2015.07.006. [73]ZHOU Y,YIN P R,LI B,et al.Effect of sedative-hypnotic medicines on mortality in peritoneal dialysis patients with sleep disorders:a retrospective cohort study[J].Blood Purif,2018,45(1/2/3):95-101.DOI:10.1159/000484922. [74]GRIVA K,JAYASENA D,DAVENPORT A,et al.Illness and treatment cognitions and health related quality of life in end stage renal disease[J].Br J Health Psychol,2009,14(Pt 1):17-34.DOI:10.1348/135910708X292355. [75]王春花,高磊平,周育锋.谷维素与艾司唑仑治疗维持性血液透析患者失眠的疗效比较[J].临床肾脏病杂志,2018,18(10):643-644.DOI:10.3969/j.issn.1671-2390.2018.10.012. [76]EDALAT-NEJAD M,HAQHVERDI F,HOSSEIN-TABAR T,et al.Melatonin improves sleep quality in hemodialysis patients[J].Indian J Nephrol,2013,23(4):264-269.DOI:10.4103/0971-4065.114488. [77]高云,马玉华,夏志银,等.不同耳穴刺激对维持性血液透析患者睡眠质量的影响[J].实用临床医药杂志,2017,21(14):58-60.DOI:10.7619/jcmp.201714017. GAO Y,MA Y H,XIA Z Y,et al.Effects of different auricular acupoints stimulating on sleep quality of maintenance hemodialysis patients[J].Journal of Clinical Medicine in Practice,2017,21(14):58-60.DOI:10.7619/jcmp.201714017. |
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