本文選題：成年人 + 睡眠質(zhì)量　； 參考：《浙江大學》2015年碩士論文

【摘要】：背景：隨著當今信息時代發(fā)展步伐的逐步加快,社會經(jīng)濟迅猛發(fā)展,人們生活節(jié)奏也隨之加快,造成人們工作趨忙、壓力增大。上班族們面臨不同的健康隱患,人的負性情緒和睡眠障礙也隨之而來。良好的睡眠質(zhì)量有助于提高人們的工作、生活、學習效率和保持較好的社會適應能力。腎上腺皮質(zhì)分泌的皮質(zhì)醇是調(diào)節(jié)人體內(nèi)分泌系統(tǒng)的重要組分,下丘腦-垂體-腎上腺軸(HPA軸)的晝夜分泌生理節(jié)律會影響它的水平波動。類似皮質(zhì)醇激素水平的晝夜節(jié)律變化具有調(diào)節(jié)神經(jīng)內(nèi)分泌、穩(wěn)定內(nèi)環(huán)境、調(diào)節(jié)免疫、抗氧化、調(diào)節(jié)人體正常睡眠周期、使人體適應外界環(huán)境變化、協(xié)調(diào)人體生理反應等多種功能。目的：探討唾液皮質(zhì)醇與睡眠質(zhì)量的關系,分析唾液皮質(zhì)醇對睡眠障礙的評價診斷價值。方法：采用整群抽樣法對杭州市2家大型企業(yè)職工進行體檢,按納入和排除標準選取571名成年人為研究對象(年齡20-60周歲),收集年齡、性別、身高、體重等資料,收集唾液樣本,用光化學免疫法測定唾液皮質(zhì)醇水平。采用匹茲堡睡眠質(zhì)量指數(shù)(PSQI)對研究對象進行睡眠質(zhì)量調(diào)查,對研究對象近一個月來主觀睡眠質(zhì)量進行評定。結果：研究對象中有46.8%的人出現(xiàn)睡眠障礙,其中女性研究對象的睡眠質(zhì)量要比男性研究對象的睡眠質(zhì)量差(p0.05)。唾液皮質(zhì)醇水平和PSQI評分呈正相關(spearman相關系數(shù)=0.632,p0.01)。男性研究對象工作特征曲線(ROC曲線)分析唾液皮質(zhì)醇對睡眠障礙的診斷價值,曲線下面積(AUC)為0.873(95%置信區(qū)間為：0.839-0.911),最接近ROC曲線左上角的唾液皮質(zhì)醇水平濃度6.55nmol/L為篩檢試驗最佳陽性臨界點,其對應的靈敏度為78.5%,特異性為84.0%。女性研究對象工作特征曲線分析唾液皮質(zhì)醇對睡眠障礙的診斷價值,曲線下面積(AUC)為0.885(95%置信區(qū)間為：0.841-0.929),最接近ROC曲線左上角的唾液皮質(zhì)醇水平濃度7.40nmol/L為篩檢試驗最佳陽性臨界點,其對應的靈敏度為68.3%,特異性為87.8%。結論：唾液皮質(zhì)醇水平與睡眠質(zhì)量有很強的相關性,睡眠障礙程度的加深伴隨著唾液皮質(zhì)醇水平的升高。唾液皮質(zhì)醇檢測可考慮作為睡眠障礙診斷的一種輔助手段。
[Abstract]:Background: with the rapid development of the information age, the rapid development of social economy, people's rhythm of life is also accelerated, resulting in people tend to work busy, increased pressure. Office workers face different health risks, followed by negative emotions and sleep disorders. Good sleep quality helps to improve people's work, life, learning efficiency and social adaptability. Cortisol secreted by the adrenal cortex is an important component of the endocrine system. The circadian rhythm of the hypothalamus-pituitary-adrenal axis (HPA axis) may affect its level fluctuation. Circadian rhythms similar to cortisol levels regulate neuroendocrine, stabilize the internal environment, regulate immunity, antioxidation, regulate the body's normal sleep cycle, and enable the human body to adapt to changes in the external environment. Coordinate human physiological response and other functions. Objective: to investigate the relationship between salivary cortisol and sleep quality and to analyze the diagnostic value of salivary cortisol in sleep disorder. Methods: a total of 571 adults (20-60 years old) were selected by cluster sampling for physical examination of two large enterprises in Hangzhou. The data of age, sex, height and weight were collected. The salivary cortisol levels were measured by photochemical immunoassay. Pittsburgh Sleep quality Index (PSQI) was used to evaluate the subjective sleep quality of the subjects. Results: 46.8% of the subjects had sleep disorders, and the sleep quality of female subjects was worse than that of male subjects (p0.05). There was a positive correlation between salivary cortisol level and PSQI score (spearman correlation coefficient was 0.632p0.01). The diagnostic value of salivary cortisol in sleep disorders was analyzed by work characteristic curve (ROC curve) in male subjects. The area under the curve (AUC) was 0.873 (95% confidence interval: 0: 0.839-0.911). The salivary cortisol concentration closest to the upper-left corner of the ROC curve was 6.55 nmol / L, which was the best positive critical point for the screening test. The sensitivity was 78.5 and the specificity was 84.0. The diagnostic value of salivary cortisol on sleep disorder was analyzed by working characteristic curve of female subjects. The area under the curve (AUC) was 0.885 (95% confidence interval: 0: 0.841-0.929). The salivary cortisol concentration closest to the upper left corner of the ROC curve was 7.40nmol / L, which was the best positive critical point for the screening test. The sensitivity was 68.3% and the specificity was 87.8%. Conclusion: salivary cortisol level has a strong correlation with sleep quality, and the degree of sleep disorder is associated with the increase of salivary cortisol level. Salivary cortisol detection may be considered as an auxiliary method for the diagnosis of sleep disorders.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R740

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本文編號：2093251