食管癌患者放疗联合免疫治疗期间睡眠障碍的临床特征及影响因素分析OA
Clinical Characteristics and Influencing Factors of Sleep Disorders in Patients with Esophageal Cancer During Radiotherapy Combined with Immunotherapy
目的:探讨食管癌患者在接受放疗联合免疫治疗期间睡眠障碍的发生率、临床特征及其相关影响因素.方法:选取2022年1月至2024年12月南通大学附属肿瘤医院收治的接受放疗联合免疫治疗的食管癌患者75例作为研究对象,采用匹兹堡睡眠质量指数量表(PSQI)从治疗第4周开始评估睡眠状况,PSQI总分＞7分定义为存在睡眠障碍.分析患者睡眠障碍发生率,依照睡眠障碍发生情况分为观察组(n=48)及对照组(n=27),分析睡眠障碍的临床特征及影响因素.结果:75例患者中,共48例发生睡眠障碍,发生率为64.00％(48/75).对48例睡眠障碍患者的睡眠特征进行分析,入睡困难、夜间易醒、早醒的发生率均超过70％;观察组患者总睡眠时间、睡眠效率、N2期睡眠比例、N3期睡眠比例、快速眼动(REM)期睡眠比例显著低于对照组,睡眠潜伏期、入睡后清醒时间、N1期睡眠比例显著高于对照组,差异有统计学意义(P＜0.05);睡眠障碍的发生与年龄、文化程度、临床分期、放射性食管炎、疲乏、疼痛、焦虑状态、抑郁状态显著相关,差异有统计学意义(P＜0.05);中重度疲乏、存在焦虑状态、抑郁状态是患者发生睡眠障碍的独立危险因素,差异有统计学意义(P＜0.05).结论:食管癌患者放疗联合免疫治疗期间睡眠障碍发生率高达64.00％,睡眠状态及睡眠比例出现显著变化,主要与疲乏、焦虑、抑郁状态密切相关,临床需予以重点筛查与干预.
Objective:To investigate the incidence,clinical characteristics,and related influencing factors of sleep disorders in patients with esophageal cancer during radiotherapy combined with immunotherapy.Methods:A prospective study was conducted on 75 patients with esophageal cancer who received radiotherapy combined with immunotherapy at the Affiliated Cancer Hospital of Nantong University/Nantong Tumor Hospital from January 2022 to December 2024.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate their sleep status from the fourth week of treatment,with a total PSQI score＞7 defined as the presence of sleep disorders.The incidence of sleep disorders in patients was analyzed.Based on the occurrence of sleep disorders,the patients were divided into an observation group(n=48)and a control group(n=27)to evaluate the clinical characteristics and influen-cing factors of sleep disorders.Results:Among the 75 patients,48 experienced sleep disorders,with an incidence rate of 64.00％(48/75).An analysis of the 48 patients with sleep disorders revealed that the incidence of difficulty initiating sleep,frequent noc-turnal awakenings,and early morning awakening all exceeded 70％.The total sleep time,sleep efficiency,N2 phase sleep propor-tion,N3 phase sleep proportion,and rapid eye movement(REM)sleep proportion of patients in the observation group were signifi-cantly lower than those in the control group.The sleep latency,wake after sleep onset(WASO),and N1 phase sleep proportion were significantly higher than those in the control group,and the differences were statistically significant(P＜0.05).The occur-rence of sleep disorders was significantly correlated with age,educational level,clinical stage,radiation esophagitis,fatigue,pain,anxiety state,and depression state(P＜0.05).Moderate-to-severe fatigue,anxiety,and depression were independent risk factors for patients to develop sleep disorders(P＜0.05).Conclusion:The incidence of sleep disorders in esophageal cancer patients during radiotherapy combined with immunotherapy is as high as 64.00％,and there are significant changes in sleep status and sleep proportion,which are mainly closely related to fatigue,anxiety,and depression.Clinical screening and intervention should be given priority.
张紫寒;沈健;杨百霞
南通大学附属肿瘤医院/南通市肿瘤医院,南通,226361南通大学附属肿瘤医院/南通市肿瘤医院,南通,226361南通大学附属肿瘤医院/南通市肿瘤医院,南通,226361
医药卫生
食管肿瘤放射治疗免疫治疗睡眠障碍匹兹堡睡眠质量指数影响因素
Esophageal cancerRadiotherapyImmunotherapySleep disordersPittsburgh Sleep Quality IndexInfluencing factors
《世界睡眠医学杂志》 2026 (2)
253-256,4
南通市卫生健康委员会科研课题(MS2023059).
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